Propranolol can reduce the risk of ischemic stroke in women with migraines

Propranolol, a beta blocker medication used to treat high blood pressure and prevent migraines, had a stronger protective effect for the risk of ischemic stroke in women with migraine, particularly those without aura. However, the medicine did not have the same protective effect on men.

The headaches by migraine are common in the general population, but three times more often occur in women than in men. This weakening condition is associated with a higher risk of stroke. While the Beta blocker propranolol can be used to prevent migraines, its effectiveness to reduce the general risk of stroke is still uncertain.

“The migraine is a risk factor often ignored for cardiovascular problems. Until recently, preventive treatments for people who have migraines were not available,” said the lead author of the Mulubhan Mogos, Ph.D., M. study, M. SC., FAHA, Assistant Professor at the Nursing School of Vanderbilt University in Nashville, Tennessee. “Many women suffer from migraines, and it is important to keep in mind that Propranolol can be beneficial for these women, particularly those who experience migraine without aura. This is an important discovery for those who deal with migraines.”

Mogos also noted that migraine disproportionately affects women in communities historically with resources, and this disparity can affect the ability to achieve educational objectives or maintain stable job, creating a vicious circle. While new treatments have proven to be effective, they may not be accessible to women in these groups due to high costs.

For the study, the researchers reviewed more than 3 million electronic health records of two large databases. In separate analysis, the researchers identified people with migraine who developed stroke and those with migraine who did not develop stroke (control group). They then evaluated whether the individuals were treated with Propranolol by migraine and if that treatment had affected the risk of stroke.

“Initially we specifically analyze the general stroke and then the ischemic stroke.

After adjusting the possible variables, such as demography (age, sex, race), other conditions (high blood pressure, diabetes, etc.) and hormonal factors (use of birth control, pregnancy, considered separately for each woman) that could affect results the analysis found:

• Propranolol was significantly associated with a reduced risk of ischemic stroke in women with migraine, particularly in those without aura. The risk of developing a stroke was 52% lower for women who take the medication in an analysis of the database and 39% lower in the other. There was no reduction in the risk of stroke in men in any analysis group.
• The protective effect of Propranolol was stronger for ischemic stroke and in women with migraine without Aura. The aura of migraine can include disturbances, such as flashing lights, blind spots, zigzag patterns or see color points. Other symptoms include tingling or numbness in the face or hands, difficulty speaking, dizziness or confusion.
• Secondary analyzes showed lower cerebrovascular accident rates in women who take propranolol in multiple points of time in both databases.

“Our findings indicate that health and health professionals should discuss the advantages of preventive interventions of migraine. For people with resources little resources that have a greater burden of this condition and can lack access to new treatments, we must ensure that these treatments are available to them.

“Aura without aura can often overlook as a risk factor for stroke, especially in women, in which previous literature has shown that migraine is a stronger and more important risk factor compared to Men. Obtain when studying women and men separately: we can take advantage of known sex differences in the risk factors of stroke and move towards more personalized attention, “said Tracy E. Madsen, MD, pH, pH, pH. .D., President of the American Heart Association Cardiology (CLCD)/Women’s Health Sciences Committee and Associate Professor of Emergency Medicine at Robert Larner, MD College of Medicine of the University of Vermont. Madsen did not participate in the study.

The main limitation is that this was a review of the past data using electronic health records, which can introduce biases, such as erroneous classification errors of dependence on ICD codes (codes used to classify and inform the conditions and diseases and diseases health). These findings highlight the need for studies that wait in time to confirm these results.

Study details, background or design:

• Using existing data, the study evaluated the effect of migraine treatments to reduce the risk of stroke. The study used two unidentified electronic health records database Health (NIH).
• The study was conducted at the Nursing School of the University of Vanderbilt and in the Department of Biomedical Informatics of the University of Vanderbilt Medical Center in Nashville.
• The SD database of the Medical Center of the University of Vanderbilt includes disadvantaged longitudinal research data of more than 3 million people that cover more than 15 years. As of May 2024, the research program of all the USA has data from electronic health records for more than 230,000 diverse participants in the United States.
• The SD database is more specific in the region with a relatively similar population, while the database of all the USA. Includes a broader and diverse representative population of several regions of the United States. This could explain some of the differences found.
• The researchers included men and women with a primary diagnosis of stroke after the start of the first migraine. People in the control group did not have a diagnosis of stroke after the first start of migraine.