Use of Nitroglycerin in Patients with Aortic Stenosis

Tradition teaches that nitrates should be avoided in patients with aortic stenosis because of their dependence on preload. Investigators conducted a retrospective cohort study to assess the incidence of hypotension after nitrate treatment among patients with severe, moderate, or no aortic stenosis. After age matching, 65 patients were in each group.

Nitroglycerin was given intravenously in 70% of patients, sublingually in 5%, and both in 25%. The incidence of clinically relevant hypotension was 26.2% for both the moderate- and severe-stenosis groups and 23.1% for the no-stenosis group. In a controlled multivariable analysis, moderate and severe aortic stenosis were not associated with clinically relevant hypotension after receipt of nitrogly…