Aldehyde dehydrogenase 2 (Aldehyde Dehydrogenase Gene 2, ALDH2) metabolizes nitroglycerin into nitric oxide with vaso-expanding activity, thereby dilating blood vessels and relieving the conditions of patients with angina pectoris and myocardial infarction. The ALDH2 gene is not only involved in the metabolism of nitroglycerin, but also in the catabolism of alcohol in the human body.

In some patients, sublingual nitroglycerin cannot quickly and effectively relieve angina pectoris, but instead leads to aggravation of myocardial ischemia. The study found that in patients with ALDH2 (Glu504Lys) mutation, the nitroesterase activity of acetaldehyde dehydrogenase 2 will be reduced by more than 10 times, so that nitroglycerin cannot produce nitric oxide, and it is difficult to exert its efficacy. The mutation of the ALDH2 (Glu504Lys) gene can also cause the normal metabolic pathway of alcohol in the body to be blocked, and a large amount of acetaldehyde will remain in the body, causing damage to the body.