A new study has found that almost all blood-pressure-lowering medications reduce the number of headaches migraine sufferers have each month. Researchers say that these medications could be a more affordable and accessible alternative to migraine medications.
A throbbing headache with pulsing is a common migraine symptom. It’s more than just a bad headache. Migraines can cause debilitating symptoms, including sensitivity to sound, light or smells. This can make it difficult to function. The severity of pain and the symptoms can change. Around 15% of the population is believed to be affected by migraine.
Migraine medications can be expensive, but they are effective in preventing future attacks and reducing symptoms. In 2020, migraine treatment in the US cost between US$2,000 and over $9,000 per year per person. Insurance may not have covered this. Blood-pressure-lowering medications, known as antihypertensives, are sometimes prescribed as a preventative to reduce how often migraines occur and the length and severity of headaches. Current prescribing guidelines recommend a few classes of blood-pressure (BP) medications: beta-blockers and angiotensin II antagonist receptor blockers (ARB).
Researchers at The George Institute for Global Health, Sydney, Australia, have found that almost all antihypertensive classes can reduce headaches for migraine sufferers.
This study shows that GPs can prescribe common BP medications to patients with migraines or severe headache episodes.
Researchers performed a meta analysis of all randomized studies of antihypertensives for the prevention of episodic headaches, defined as fewer than 15 headache days in a month. The analysis included 50 studies and 4,310 participants. They looked at the effectiveness of BB and ARB in addition to alpha-blockers (AB), angiotensin-converting enzyme inhibitors (ACEi), and calcium channel blockers (CCB), compared to a placebo.
Before we dive into the study findings, let’s take a look at how each class of drugs reduces BP, without going into great detail about their physiological effects, and a few common brand names. Beta-blockers, such as Tenormin, Lopressor Toprol and Levatol, lower heart rate. ACEi (Capoten Monopril Accupril Lotensin) reduces the production of angiotensin which helps to relax and dilate the blood vessels. ARB (Atacand Micardis Avapro) blocks the angiotensin effect, producing a similar outcome to ACEi. CCB (Norvasc Plendil Adalat) prevents calcium from entering muscle cells in the heart and arteries. This results in dilated blood vessels, a reduced heart rate, and a dilation of narrowed arteries. AB reduces resistance to arteries by relaxing the muscle tone.
Researchers found that each class of drugs had a lower number headache days per month compared with a placebo. The exception was those taking ACEi, or a combination antihypertensives. CCB was the drug that reduced monthly headache days the most. Antihypertensives, on average, reduced the number headache days per month in addition to the placebo effect by one day.
Researchers say that their findings are “clinically important” due to the availability and lower cost of antihypertensives and health insurance coverage. Weight gain and drowsiness are two common side effects of migraine medication.
Faraidoon Haghdoost is one of the study co-authors. “Around 90 percent of migraine sufferers can be managed by general practitioners, with the goal of preventing as many episodes as they can because of their disabling effect on the patient’s life,” she said. The good news is that many blood pressure medications can be found at low prices, and some are available in generic form. They are a reliable treatment option, alongside other preventive measures like avoiding triggers or making lifestyle changes.
Researchers plan to conduct a second review to find out which antihypertensive medications work best in combating migraine headaches.
The study was published by the journal Cephalalgia.
Source: The George Institute for Global Health
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