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

Abstract

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.

The effect of local cold compresses for nitroglycerin‐induced headache: An observational pretest–posttest study

“…The Patient Information Form was developed by the researcher in line with the literature 6,20,21 and comprised two sections. The first section included questions related to the sociodemographic characteristics of patients (age, sex, marital status, educational level and occupation) and the second section included questions about disease, treatment and habits (chronic diseases, the purpose of NTG use, systolic and diastolic blood pressure (BP), chronic headache history in the family, smoking and alcohol use).…”

“…The Patient Monitoring Form included questions about BP and heart rate before and after local cold compresses, temperature of regions where cold compresses were applied (bilateral frontotemporal and occipital), temperature of the gel ice packet used, presence of headache, correlation of pain with time, region of pain, features of pain, severity of pain, factors increasing/reducing pain and symptoms accompanying headache and it was prepared with reference to similar studies on this subject. 6,7,20,21 The VAS was used to assess the headache of patients in the research, allowing values that are numerically immeasurable to be converted into numbers. VAS pain score varied between "no pain" (score = 0) and "worst pain" (score = 10).…”

Assessment of Relationship Between Subclinical Atherosclerosis and Benign Prostate Hyperplasia Using Epicardial Fat Thickness and Carotid Intima-Media Thickness

“…Ayrıca KİMK, birçok çalışmada sistemik aterosklerotik yükü ve kardiyovasküler hastalık riskini yansıtan bir parametre olarak kabul edilmiştir (6,7) .…”

“…Karotis intima media kalınlığı (KİMK), aterosklerozun erken dönem bulgularını gösteren güvenli, ucuz ve doğru bir yöntemdir. Ayrıca KİMK, birçok çalışmada sistemik aterosklerotik yükü ve kardiyovasküler hastalık riskini yansıtan bir parametre olarak kabul edilmiştir (6,7) . Günümüzde, BPH'nin aterosklerotik hastalıklar ile ilişkisini gösteren birçok veri olsa da; aterosklerozun, klinik düzeyde olmayan erken dönemi ile ilişkisi, henüz tam olarak değerlendirilmemiştir.…”