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 )
Comparison of isradipine and enalapril effects on regional carotid circulation in patients with hypertension with unilateral internal carotid artery stenosis.
This r and omized , double-blind , placebo-controlled study was aim ed at detecting cerebrovascular effects of isradipine and enalapril in patients with moderate hypertension depending on the presence and grade on unilateral stenosis of internal carotid artery ( ICA ) . We evaluated carotid vascular resistance by using Doppler analysis and regional cerebral blood flow ( rCBF ) by using 133Xe-clearance technique before and after a single 5-mg oral dose of isradipine , enalapril , or placebo . Their effects were r and omly and consecutively tested in 73 patients with essential hypertension subdivided into three groups : without carotid occlusive lesions , with moderate ( 50 - 75 % ) , and with severe ( 76 - 99 % ) unilateral asymptomatic ICA stenosis . There were no differences in age , gender , and antihypertensive effects of the drugs between these three subgroups . Three major variants of cerebrovascular drug effects were observed : absence of changes ( variant I ) , decrease in carotid vascular resistance with increase in rCBF and elimination of side-to-side asymmetry ( variant II ) , and increase in carotid vascular resistance with further reduction of rCBF ipsilaterally ICA stenosis , and increased side-to-side asymmetry ( variant III ) . Frequency of variant III was significantly higher in patients with severe ICA stenosis .  Enalapril produced variant I of cerebrovascular effects in most patients examined ; variant III was observed only in 13 % of patients with severe ICA stenosis . Isradipine produced variant I of cerebrovascular effects much less frequently than did enalapril . For this drug , variant II was most typical in patients without ICA stenosis and with moderate ICA stenosis . In 43.5 % of patients with severe ICA stenosis , however , isradipine produced reduction of cerebral perfusion . Presumably the presence of ICA stenosis , especially > 75 % , increases the risk of cerebrovascular disorders in antihypertensive therapy . In patients with severe ICA stenosis , treatment with enalapril appears to be safer than that with isradipine
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 )