Headache response to glyceryl trinitrate in patients with and without obstructive coronary artery disease

Hsi, David H.

doi:10.1136/hrt.2004.035295

Cited by 17 publications

(10 citation statements)

References 23 publications

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“…Glyceryl trinitrate (GTN) is a common chemical headache trigger that induces an extended headache period in chronic migraine patients, but only a short-lived headache in normal individuals [175,176]. In the IS rat model, GTN induces an extended period of trigeminal sensitivity and increased extracellular glutamate in the TNC [26,28].…”

Section: Adenosine and Common Headache Triggersmentioning

confidence: 99%

The Role of Adenosine Signaling in Headache: A Review

2017

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Migraine is the third most prevalent disease on the planet, yet our understanding of its mechanisms and pathophysiology is surprisingly incomplete. Recent studies have built upon decades of evidence that adenosine, a purine nucleoside that can act as a neuromodulator, is involved in pain transmission and sensitization. Clinical evidence and rodent studies have suggested that adenosine signaling also plays a critical role in migraine headache. This is further supported by the widespread use of caffeine, an adenosine receptor antagonist, in several headache treatments. In this review, we highlight evidence that supports the involvement of adenosine signaling in different forms of headache, headache triggers, and basic headache physiology. This evidence supports adenosine A2A receptors as a critical adenosine receptor subtype involved in headache pain. Adenosine A2A receptor signaling may contribute to headache via the modulation of intracellular Cyclic adenosine monophosphate (cAMP) production or 5' AMP-activated protein kinase (AMPK) activity in neurons and glia to affect glutamatergic synaptic transmission within the brainstem. This evidence supports the further study of adenosine signaling in headache and potentially illuminates it as a novel therapeutic target for migraine.

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Section: Adenosine and Common Headache Triggersmentioning

confidence: 99%

The Role of Adenosine Signaling in Headache: A Review

2017

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“…Headache is the most common side effect of nitrate ranging from 2% to 73% depending on the clinical state in literature [1][2][3]. Although headache rate has been reported separately almost in every clinical spectrum of cardiovascular diseases in which nitrate therapy is indicated, headache comparison has been performed in limited studies [4].We aimed to assess and compare the headache response rate in patients with coronary artery disease and patients with systolic heart failure of ischemic etiology.…”

mentioning

confidence: 99%

“…Recently Hsi et al has shown higher headache response to nitrate in patients with normal coronary artery compared to patients with obstructive coronary arteries (73% vs 23% respectively) [4]. They have suggested that nitrate causes less frequent headache in patients with atherosclerosis possibly due to less pronounced cerebral dilatation patients with obstructive coronary artery disease [15].…”

mentioning

confidence: 99%

Headache response to nitrate in patients with coronary artery disease and systolic heart failure

Sivri

Tekin

Erbay

et al. 2012

International Journal of Cardiology

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“…Hsi et al reported that glyceryl trinitrate causes signifi cantly more frequent headache episodes in patients with normal coronary arteries than in those with obstructive coronary artery disease (18) . This fi nding was confi rmed using glyceryl trinitrate by Cho et al, who also showed that patients with NIH had smaller CIMTs and lower heart-carotid pulse wave velocities than those without NIH (19) .…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Nitrate-Induced Headache on Atherosclerotic Burden in Patients with Stable Coronary Artery Disease

Erkan¹,

Kırış²,

Korkmaz³

et al. 2016

Kosuyolu Heart Journal

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Introduction: Nitrates, which lead to vasodilation in vessels, is one of the cornerstone drugs of antianginal therapy. The most frequently encountered side effect of nitrates is headache, which is linked to vasodilation of the cerebral arteries. Vasodilator response to nitrates is signifi cantly reduced in patients with atherosclerosis. The aim of present study was to assess the relationship between nitrate-induced headache (NIH) and systemic and coronary atherosclerotic burden in patients with stable coronary artery disease. Patients and Methods:Overall, 40 patients with NIH (group I: 61.2 ± 8.56 years, 32 males) and 62 patients without headache (group II: 63.5 ± 8.45 years, 41 males) were included in the study. Systemic atherosclerotic burden was evaluated by carotid intima-media thickness (CIMT) and cardio-ankle vascular index (CAVI). Coronary atherosclerotic burden was assessed by the Gensini score.Results: CIMT and CAVI were signifi cantly greater in group II than in group I (0.8 ± 0.20 vs. 0.6 ± 0.20 and 9.5 ± 1.0 vs. 8.4 ± 1.2, respectively; p< 0.001). The Gensini score was also higher in group II than in group I [median 32 (16.7-45.2) vs 12.5 (5.2-19.2); p< 0.001]. In multivariate analysis, headache was found as an independent determinant of CIMT, CAVI, and Gensini score (p< 0.001). Conclusion:Patients with NIH had a low level systemic and coronary atherosclerotic burden, evaluated by CIMT, CAVI, and Gensini score, compared with those without NIH.

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Headache response to glyceryl trinitrate in patients with and without obstructive coronary artery disease

Cited by 17 publications

References 23 publications

The Role of Adenosine Signaling in Headache: A Review

The Role of Adenosine Signaling in Headache: A Review

Headache response to nitrate in patients with coronary artery disease and systolic heart failure

Predictive Value of Nitrate-Induced Headache on Atherosclerotic Burden in Patients with Stable Coronary Artery Disease

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