Almost all blood pressure medications reduce migraine: Study

A large-scale review of international studies focused on blood pressure (BP) medications’ ability to prevent migraine indicates that the commonly used drugs could be more widely utilised.
 
The paper, published in Cephalgia, is reportedly the first known meta-analysis on this topic, and incorporated 50 trials involving more than 4300 people.
 
It found those taking BP-lowering medication experienced one fewer headache day per month compared to a placebo group, with the greatest reduction associated with calcium channel blockers.
 
However, while previous research has shown that certain BP medications can reduce migraine, the study’s joint principal investigator, Dr Cheryl Carcel from the George Institute, says only a few are currently recommended for migraine prevention.
 
‘For countries where new migraine medications are expensive, limited by prescribing criteria or not available at all – covering all countries to some extent – this study shows that common BP medicines, which GPs are comfortable prescribing, can be an important preventive measure for patients with migraine or severe headache episodes,’ she said.
 
‘Moreover, while we can see from the analysis that the effect is true for almost all types of BP medicines, this is not reflected in the current clinical guidelines, which specify just one or two types – such as beta-blockers – but not the full range of therapies that could be useful.’
 
According to the study, most evidence was available for beta-blockers, which showed on average 0.7 fewer monthly headache attacks, 0.4 fewer monthly headache days, one fewer monthly migraine attacks and one fewer monthly migraine days.
 
Migraine is the world’s second leading cause of disability overall – and the first among women – with global prevalence estimated at 14–15% of the population, representing a major cause of ill health for up to one billion people. 
 
Joint principal investigator and former GP Dr Faraidoon Haghdoost estimates that around 90% of these cases can be managed in general practice.
 
‘The numbers of people living with headache disorders is enormous,’ he said.
 
‘Common treatments given once an episode has taken hold can have side effects that in themselves present problems, such as drowsiness or weight gain, whereas BP meds can prevent episodes without a significant side effect burden.
 
‘The good news is that blood pressure medications are widely available at low cost, with many available in generic forms, presenting a trusted treatment option alongside other preventive measures such as avoiding triggers and making lifestyle changes.’
 
All classes of BP-lowering medications studied, including alpha-blockers, angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors, beta-blockers and calcium channel blockers reduced headache days per month more than placebo, with varying levels of efficacy.
 
A planned follow-up paper is set to provide more insight into the most effective options at a later date.
 
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