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These include impaired biotransformation of GTN [8, 9], changes of neurohumoral activity [10], phosphodiesterase activity upregulation with reduced cyclic guanosine monophosphate (cGMP) levels [11], loss of soluble guanylate cyclase (sGC) responsiveness to nitric oxide (NO) [12], depletion of sulfhydryl groups [13], and most recently, generation of free radicals [14, 15]

(2020) 182:146073.e17

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But psychological dependence on symptom relief is possible with any effective treatment

[DOI] [PMC free article] [PubMed] [Google Scholar] 107.Ishihara Y., Kawami T., Ishida A., Yamazaki T