[Headache due to nitroglycerin administration and its clinical significance].

Objectives: This study assessed the side effects of nitroglycerin administration and their clinical significance.

Methods: Adverse reactions associated with sublingual nitroglycerin administration were investigated in 103 patients, 71 men and 32 women (mean age 56 +/- 11 years), 32 patients with coronary artery stenosis and 71 without coronary artery stenosis.

Results: Fifty-one percent of patients experienced headache and 30% experienced other adverse reactions, whereas 19% experienced no adverse reactions. The relationship was investigated between headache, the most common adverse reaction, and the following eight clinical background factors: coronary angiographic findings, sex, age, hyperlipidemia, hypertension, diabetes mellitus, smoking and drinking. Multiple regression analysis was conducted by treating sublingual nitroglycerin-induced headache as an object variable and the clinical background factors as explanatory variables. Statistically, the onset of headache correlated most closely to coronary angiographic findings, followed by smoking, hypertension, diabetes mellitus and drinking. The first four factors suppressed the onset of headache, whereas drinking facilitated the onset of headache.

Conclusions: There is a close relationship between the onset of headache following sublingual nitroglycerin administration and coronary angiographic findings. Sublingual nitroglycerin-induced headache as a predictor of coronary angiographic findings has a sensitivity and specificity of 81% and 66%, respectively, for patients without coronary artery stenosis based on the absence of headache.