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 )
Long-Term Angiotensin-Converting Enzyme Inhibitor Perindopril Therapy Improves Cerebral Perfusion Reserve in Patients With Previous Minor Stroke
Background and Purpose — Angiotensin-converting enzyme ( ACE ) inhibitor – based therapy reduces the recurrence of stroke . The present study assessed the effects of long-term ACE inhibitor therapy on cerebral circulation in patients with previous minor stroke . Methods — After a run-in period , 19 patients were r and omized to ACE inhibitor therapy ( n=9 ; 4 mg of perindopril daily ; mean age , 64±8 years ; mean systolic/diastolic blood pressure [BP]±SD , 133±12/77±9 mm Hg ) or placebo therapy ( n=10 ; mean age , 66±9 years ; mean BP , 139±10/78±8 mm Hg ) . Cerebral blood flow ( CBF ) was measured during hypercapnia , normocapnia , and hypocapnia using a positron emission tomography with H215O at entry into the study and after 3 to 12 months . Cerebral perfusion reserve ( CPR ) was defined as percent CBF response to a 1 mm Hg change in arterial partial pressure of CO2 between hypercapnia and hypocapnia . Results — Systolic/diastolic BP and CBF during normocapnia showed no significant changes between entry and completion of the trial in the perindopril and placebo groups . Mean value of CPR showed a significant increase in the perindopril group ( from 3.7±1.7%/mm Hg to 4.8±1.7%/mm Hg ; P < 0.05 ) but not in the placebo group ( from 4.1±0.8%/mm Hg to 4.2±0.6%/mm Hg ; NS ) . Statistical parametric mapping analysis also showed global and significant increase ( P < 0.01 , uncorrected ) in CPR in the perindopril group alone . Conclusions — Long-term ACE inhibitor – based therapy had a beneficial effect on the cerebral circulation by improving CPR in patients with previous minor stroke
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 )