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A wider array of blood pressure-lowering medications and drug classes can effectively lower the frequency of headaches in individuals with episodic migraines, surpassing the options currently outlined in treatment guidelines.
Different blood pressure-lowering classes (like calcium channel blockers, beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and alpha-blockers) effectively reduced the frequency of headache days per month compared to placebo in episodic migraine, as deciphered from a recent systematic review and meta-analysis. The objective of the researchers was to assess how antihypertensives influence the prophylaxis of episodic migraine.
For searching randomized controlled trials investigating the impact of blood pressure-lowering medications versus placebo among individuals with episodic migraines, databases such as the Cochrane Central Registry of Controlled Trials, MEDLINE, and Embase were explored. Information was gathered on 4 endpoints: monthly migraine or headache days, and monthly migraine or headache attacks. A standardized mean difference was computed overall. A random-effects meta-analysis was subsequently carried out.
A total of 50 trials (70% of which employed a crossover design) were incorporated, making up 60 different comparisons. The mean age across all trials was 39 years, and 79% of the subjects were female. As found, monthly headache days were fewer in comparison to placebo across all medication classes, with statistical significance observed for all classes like calcium channel blockers (-1.8), beta-blockers (-0.4), angiotensin II receptor blockers (-0.9), angiotensin-converting enzyme inhibitors (-1.3), and alpha-blockers (-0.7) except 1 class.
The standardized mean difference exhibited a significant reduction across all categories of drug classes, and it was also profound for various specific medications: Verapamil, Nicardipine, Timolol, Propranolol, Metoprolol, Bisoprolol, Atenolol, Candesartan, and Clonidine. In individuals battling episodic migraine, a wider range of blood pressure-lowering medication classes and drugs exhibit the capability to minimize headache frequency compared to those currently outlined in treatment guidelines.
Cephalalgia
The effect of blood pressure lowering medications on the prevention of episodic migraine: A systematic review and meta-analysis
Cheryl Carcel et al.
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