TY - JOUR
T1 - The effect of blood pressure lowering medications on the prevention of episodic migraine : a systematic review and meta-analysis
AU - Carcel, C.
AU - Haghdoost, F.
AU - Shen, J.
AU - Nanda, P.
AU - Bai, Y.
AU - Atkins, E.
AU - Torii-Yoshimura, T.
AU - Clough, A.J.
AU - Davies, L.
AU - Cordato, Dennis
AU - Griffiths, L.R.
AU - Balicki, G.
AU - Wang, X.
AU - Vidyasagar, K.
AU - Malavera, A.
AU - Anderson, C.S.
AU - Zagami, A.S.
AU - Delcourt, C.
AU - Rodgers, A.
PY - 2023/6
Y1 - 2023/6
N2 - Background: Currently, only a few specific blood pressure-lowering medications are recommended for migraine prevention. Whether benefits extend to other classes or drugs is uncertain. Methods: Embase, MEDLINE, and the Cochrane Central Registry of Controlled Trials were searched for randomized control trials on the effect of blood pressure-lowering medications compared with placebo in participants with episodic migraine. Data were collected on four outcomes – monthly headache or migraine days, and monthly headache or migraine attacks, with a standardised mean difference calculated for overall. Random effect meta-analysis was performed. Results: In total, 50 trials (70% of which were crossover) were included, comprising 60 comparisons. Overall mean age was 39 years, and 79% were female. Monthly headache days were fewer in all classes compared to placebo, and this was statistically significant for all but one class: alpha-blockers −0.7 (95% CI: −1.2, −0.1), angiotensin-converting enzyme inhibitors −1.3 (95% CI: −2.9, 0.2), angiotensin II receptor blockers −0.9 (−1.6, −0.1), beta-blocker −0.4 (−0.8, −0.0) and calcium channel blockers −1.8 (−3.4, −0.2). Standardised mean difference was significantly reduced for all drug classes and was separately significant for numerous specific drugs: clonidine, candesartan, atenolol, bisoprolol, metoprolol, propranolol, timolol, nicardipine and verapamil. Conclusion: Among people with episodic migraine, a broader number of blood pressure-lowering medication classes and drugs reduce headache frequency than those currently included in treatment guidelines. Trial Registration: The study was registered at PROSPERO (CRD42017079176).
AB - Background: Currently, only a few specific blood pressure-lowering medications are recommended for migraine prevention. Whether benefits extend to other classes or drugs is uncertain. Methods: Embase, MEDLINE, and the Cochrane Central Registry of Controlled Trials were searched for randomized control trials on the effect of blood pressure-lowering medications compared with placebo in participants with episodic migraine. Data were collected on four outcomes – monthly headache or migraine days, and monthly headache or migraine attacks, with a standardised mean difference calculated for overall. Random effect meta-analysis was performed. Results: In total, 50 trials (70% of which were crossover) were included, comprising 60 comparisons. Overall mean age was 39 years, and 79% were female. Monthly headache days were fewer in all classes compared to placebo, and this was statistically significant for all but one class: alpha-blockers −0.7 (95% CI: −1.2, −0.1), angiotensin-converting enzyme inhibitors −1.3 (95% CI: −2.9, 0.2), angiotensin II receptor blockers −0.9 (−1.6, −0.1), beta-blocker −0.4 (−0.8, −0.0) and calcium channel blockers −1.8 (−3.4, −0.2). Standardised mean difference was significantly reduced for all drug classes and was separately significant for numerous specific drugs: clonidine, candesartan, atenolol, bisoprolol, metoprolol, propranolol, timolol, nicardipine and verapamil. Conclusion: Among people with episodic migraine, a broader number of blood pressure-lowering medication classes and drugs reduce headache frequency than those currently included in treatment guidelines. Trial Registration: The study was registered at PROSPERO (CRD42017079176).
UR - https://hdl.handle.net/1959.7/uws:77945
U2 - 10.1177/03331024231183166
DO - 10.1177/03331024231183166
M3 - Article
SN - 0333-1024
VL - 43
JO - Cephalalgia
JF - Cephalalgia
IS - 6
ER -