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CGMP then activates a cGMP dependent protein kinase which in turn stimulates the uptake of calcium by the endoplasmic reticulum of the muscle cell. The reduced levels of cytoplasmic calcium cause the muscle cell to relax.

Additionally, the use of angiotensin-converting enzyme (ACE) inhibitors and a favorable lipid panel were associated with a positive response to L-arginine treatment. L-arginine produced peripheral vasodilation in coronary artery disease patients in 1 trial. 67 In another clinical trial, oral L-arginine therapy was ineffective in improving nitric oxide bioavailability in patients with coronary artery disease. 68 Patients with angina showed improved exercise tolerance after L-arginine supplementation. 69 Patients with long-term limb ischemia who underwent implantation of autologous bone marrow cells and received antioxidants and L-arginine daily for 6 weeks experienced improvements in ankle brachial index at 3- and 12-months posttreatment.

How should I take nitroglycerin. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. If you use too much nitroglycerin, it might stop working as well in controlling your symptoms.]