Antihypertensive drugs reduce headache but it is unclear whether there are differences between drug classes .
Calcium channel blockers ( CCBs ) decrease variability in systolic blood pressure ( SBPV ) and stroke risk more than other classes , possibly due to decreased vascular tone .
If so , there might be a correlation between drug-class effects on variability in SBP and on headache .
Antihypertensive drugs reduce headache but the effect differs between classes , corresponding to their effects on SBPV and the risk of stroke .
This may partly be explained by consistent antihypertensive class effects on vascular tone in the peripheral ( variability ) and cerebrovascular circulations ( headache )
Prophylactic treatment of migraine with an angiotensin II receptor blocker: a randomized controlled trial.
CONTEXT There is a paucity of effective , well-tolerated drugs available for migraine prophylaxis . OBJECTIVE To determine whether treatment with the angiotensin II receptor blocker c and esartan is effective as a migraine-prophylactic drug . DESIGN AND SETTING R and omized , double-blind , placebo-controlled crossover study performed in a Norwegian neurological outpatient clinic from January 2001 to February 2002 . PATIENTS Sixty patients aged 18 to 65 years with 2 to 6 migraine attacks per month were recruited mainly from newspaper advertisements . INTERVENTIONS A placebo run-in period of 4 weeks was followed by two 12-week treatment periods separated by 4 weeks of placebo washout . Thirty patients were r and omly assigned to receive one 16-mg c and esartan cilexetil tablet daily in the first treatment period followed by 1 placebo tablet daily in the second period . The remaining 30 received placebo followed by c and esartan . MAIN OUTCOME MEASURES The primary end point was number of days with headache ; secondary end points included hours with headache , days with migraine , hours with migraine , headache severity index , level of disability , doses of triptans , doses of analgesics , acceptability of treatment , days of sick leave , and quality -of-life variables on the Short Form 36 question naire . RESULTS In a period of 12 weeks , the mean number of days with headache was 18.5 with placebo vs 13.6 with c and esartan ( P = .001 ) in the intention-to-treat analysis ( n = 57 ) . Some secondary end points also favored c and esartan , including hours with headache ( 139 vs 95 ; P<.001 ) , days with migraine ( 12.6 vs 9.0 ; P<.001 ) , hours with migraine ( 92.2 vs 59.4 ; P<.001 ) , headache severity index ( 293 vs 191 ; P<.001 ) , level of disability ( 20.6 vs 14.1 ; P<.001 ) and days of sick leave ( 3.9 vs 1.4 ; P = .01 ) , although there were no significant differences in health-related quality of life . The number of c and esartan responders ( reduction of > or = 50 % compared with placebo ) was 18 ( 31.6 % ) of 57 for days with headache and 23 ( 40.4 % ) of 57 for days with migraine . Adverse events were similar in the 2 periods . CONCLUSION In this study , the angiotensin II receptor blocker c and esartan provided effective migraine prophylaxis , with a tolerability profile comparable with that of placebo
Antihypertensive drugs reduce headache but it is unclear whether there are differences between drug classes .
Calcium channel blockers ( CCBs ) decrease variability in systolic blood pressure ( SBPV ) and stroke risk more than other classes , possibly due to decreased vascular tone .
If so , there might be a correlation between drug-class effects on variability in SBP and on headache .
Antihypertensive drugs reduce headache but the effect differs between classes , corresponding to their effects on SBPV and the risk of stroke .
This may partly be explained by consistent antihypertensive class effects on vascular tone in the peripheral ( variability ) and cerebrovascular circulations ( headache )