March 4, 2024

Nearly all blood pressure-lowering medications reduce the number of monthly headaches experienced by migraine sufferers, a new study finds. The drugs may offer a less expensive and more accessible treatment option than existing migraine medications, the researchers say.

A throbbing, throbbing headache is a common symptom of migraine. But it’s not just as bad as a headache. Migraines cause debilitating pain and sensitivity to light, sound, or smell that interfere with a person’s ability to function. Both symptoms and pain severity are variable, and it is estimated that migraine affects approximately 15% of the world’s population.

Migraine medications are designed to stop symptoms and prevent future attacks, but they can be expensive.exist 2020 Migraine treatment can cost $2,000 to over $9,000 per person per year in the United States and may not be covered by insurance. Medications to lower blood pressure (called antihypertensives) are sometimes used as a preventive measure to reduce the frequency of migraines and the duration and severity of the headaches. Current prescribing guidelines recommend several classes of blood pressure (BP) medications, beta-blockers (BBs), and angiotensin II receptor blockers (ARBs) for the treatment of migraine.

A new study by researchers at The George Institute for Global Health in Sydney, Australia, has found that almost all classes of antihypertensive drugs have some ability to reduce headache frequency in migraineurs.

“For countries where new migraine medications are expensive, limited by prescribing standards, or not available at all (covering to some extent all countries), this study shows that common blood pressure medications that GPs are willing to prescribe can be An important precaution for patients with migraine or severe headache attacks,” said Cheryl Cassel, lead author of the study.

We performed a meta-analysis of all randomized trials of antihypertensive drugs for the prevention of episodic migraine (defined as fewer than 15 headache days per month). The analysis included 50 trials and 4,310 participants. They studied the effectiveness of BBs and ARBs, alpha blockers (ABs), angiotensin converting enzyme inhibitors (ACEi) and calcium channel blockers (CCBs) compared with placebo.

Before we get into the study results, a brief description of how each drug lowers blood pressure without going into detail about its physiological effects, and some common brand names. Beta-blockers (eg, Tenormin, Lopressor, Toprol, Levatol) can decrease heart rate and cardiac output. ACEi (Capoten, Monopril, Accupril, Lotensin) reduce the production of angiotensin, which helps blood vessels relax and dilate. ARBs (Atacand, Micardis, Avapro) block the action of angiotensin and produce similar results to ACEi. CCBs (Norvasc, Plendil, Adalat) block calcium from getting into the muscle cells of the heart and arteries, which widens narrowed blood vessels and lowers the heart rate. AB relaxes the muscle tone in the arteries, reducing their resistance.

The researchers found that each drug class had fewer headache days per month compared with placebo, except for patients taking ACEi or combination antihypertensive drugs. CCB produced the greatest reduction in monthly headache days. On average, the antihypertensive drugs reduced the number of headache days by about one day per month, in addition to the average effect of the placebo.

The researchers said their findings are “clinically relevant” given the cost and availability of antihypertensive drugs, health insurance coverage, and the low incidence of side effects. Common side effects of migraine medications include weight gain and drowsiness.

“Approximately 90 percent of people with migraine can be managed with usual treatment, with the goal of preventing as many migraine attacks as possible, as migraine can adversely affect a patient’s quality of life,” said Faradoon, one of the study’s co-authors. said Faraidoon Haghdoost. -author. “The good news is that blood pressure medications are widely available at low cost, many of which are generic, and together with other preventive measures such as avoiding triggers and making lifestyle changes, offer a trusted treatment option.”

The researchers plan to conduct further reviews to provide more information on the specific antihypertensive drugs that are most effective against migraine-related headaches.

The study was published in the journal Headache.

source: The George Institute for Global Health