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 )
Effect of Perindopril on Cerebral and Renal Perfusion in Stroke Patients With Carotid Disease
Background and Purpose — The purpose of this study was to investigate the effect of the angiotensin-converting enzyme inhibitor perindopril on mean arterial blood pressure ( MABP ) , cerebral blood flow ( CBF ) , and glomerular filtration rate in hypertensive stroke patients with moderate to severe internal carotid artery ( ICA ) disease or ICA occlusion . Methods — Twenty-four nonacute ischemic stroke patients who had MABP readings > 100 mm Hg and moderate to severe ICA stenosis or occlusion were r and omized to receive perindopril 4 mg daily or placebo for 14 days . MABP , ICA flow , and both middle cerebral artery ( MCA ) velocity and resistance index were measured before dose , at 5 time points over the subsequent 24 hours , and finally at 2 weeks . Brain hexamethyl propylene amine oxide single photon emission computed tomography scans were performed before drug administration and at time of peak drug effect ( 6 to 8 hours ) after the first dose . Glomerular filtration rate was measured with 51Cr EDTA before medication and at 14 days . Results — A placebo-corrected BP fall of 17/10 mm Hg was seen ( P = 0.017 ) , which was maximal at 5.5 hours . No significant change in ICA flow or MCA velocity was seen between groups . No significant change in hemispheric CBF was seen . The mean change from baseline in the treated group was −0.79 mL · 100 g−1 · min−1 ( 95 % confidence interval [ CI ] , 1.65 to −3.23 ) ; mean change in the placebo group was −1.9 mL · 100 g−1 · min−1 ( 95%CI , 3.02 to −6.92 ) . Peri-infa rct CBF was similarly unaffected . One of the treated patients developed transient acute renal impairment and was withdrawn from the study on day 4 . Conclusions — Perindopril lowers BP without lowering CBF in hypertensive stroke patients with moderate to severe ICA stenosis or occlusion ; monitoring of this patient population for the complications of renal artery stenosis should be considered
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 )