Abstract
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. We determined antihypertensive class effects on SBPV and headache during follow-up in a systematic review of randomized controlled trials. We determined pooled estimates of treatment effect on group variability in BP (variance ratio, VR) and on the odds ratio for headache (OR) by random-effects meta-analysis. Antihypertensive drugs reduced the incidence of headache compared to placebo (OR = 0.75, 95% CI 0.69-0.82, p < 0.0001, 198 comparisons, 43,672 patients), but there was significant heterogeneity between drug classes (p = 0.0007) with a greater effect of beta-blockers compared to placebo (VR = 0.49, 0.33-0.68, p < 0.0001, 16 trials) or all other drug classes (OR = 0.73, 0.62-0.85, p = 0.0002, 49 trials) and a lack of effectiveness of CCBs (vs. placebo-OR = 0.95, 0.79-1.15, 65 trials; vs. other drugs-OR = 1.19, 1.05-1.35, p = 0.009, 101 trials). Drug-cl...Continue Reading
References
Jan 1, 1992·Cardiology·B WaeberM Mannhart
May 1, 1989·Clinical Cardiology·F AvanziniF Pirone
Jan 17, 1987·British Medical Journal·F AvanziniM Villella
Sep 28, 1972·The New England Journal of Medicine·N S Weiss
Nov 11, 1983·JAMA : the Journal of the American Medical Association·G D SolomonL J Spaccavento
Aug 1, 1993·Archives of Neurology·D R LiskB J Barron
Dec 5, 1997·Journal of Cardiovascular Pharmacology·S E Akopov, N A Simonian
Aug 13, 1998·Journal of the Neurological Sciences·E TroisiM Silvestrini
Apr 25, 2000·Journal of Hypertension·P KruszewskiB Krupa-Wojciechowska
Feb 7, 2001·Stroke; a Journal of Cerebral Circulation·M R WaltersK R Lees
May 12, 2001·Journal of Cardiovascular Pharmacology·A SempliciniA C Pessina
Aug 16, 2001·Cardiovascular Drugs and Therapy·W PieniazekT Jasiński
Dec 31, 2002·JAMA : the Journal of the American Medical Association·Erling TronvikGunnar Bovim
Oct 28, 2003·Journal of Human Hypertension·F D FuchsG Nunes
Apr 21, 2004·Journal of Hypertension·Fozia S NazirKennedy R Lees
Apr 24, 2004·The Cochrane Database of Systematic Reviews·K Linde, K Rossnagel
Jul 17, 2004·Stroke; a Journal of Cerebral Circulation·Jun HatazawaYuko Miura
Jun 23, 2005·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Naohiko OkuJun Hatazawa
Oct 12, 2005·Circulation·Malcolm LawNicholas Wald
Jan 1, 1991·Journal of Cardiovascular Pharmacology·I H Osterloh
Aug 31, 2006·British Journal of Clinical Pharmacology·M R LawN J Wald
Feb 21, 2009·American Journal of Hypertension·Jurgen A H R ClaassenRong Zhang
Apr 15, 2009·Cerebrovascular Diseases·Gillian M SarePhilip M W Bath
Nov 21, 2009·Acta Neurologica Scandinavica·K-S HongS-H Park
Mar 17, 2010·Lancet·Peter M RothwellNeil R Poulter
Mar 17, 2010·Lancet·Alastair J S WebbPeter M Rothwell
Mar 17, 2010·Lancet·Peter M Rothwell
Mar 17, 2010·Lancet Neurology·Peter M RothwellUNKNOWN ASCOT-BPLA and MRC Trial Investigators
Jul 29, 2011·Neurology·Alastair John Stewart WebbPeter Malcolm Rothwell
Aug 6, 2011·Stroke; a Journal of Cerebral Circulation·Alastair John Stewart Webb, Peter Malcolm Rothwell
Jan 1, 2000·Blood Pressure· Andrea Semplicini Andrea Maresca Cinzia Simonella Franca Chierichetti Paolo Pauletto Giorgio Meneghetti Giorgio Ferlin Achil
Citations
Oct 26, 2013·Current Hypertension Reports·Zbigniew GaciongJacek Lewandowski
May 5, 2016·Stroke; a Journal of Cerebral Circulation·Alastair J S Webb, Peter M Rothwell
Feb 15, 2019·Blood Pressure Monitoring·Karen O B AppiahVictoria J Haunton
May 18, 2019·The European Respiratory Journal·Esther Sapiña-BeltránUNKNOWN Spanish Sleep and Breathing Group
Oct 18, 2014·Sleep·Camila F RizziSergio Tufik
Oct 5, 2018·Respirology : Official Journal of the Asian Pacific Society of Respirology·Shane A LandryDarren Mansfield
Feb 20, 2019·Hypertension·Meghna P MansukhaniVirend K Somers
Dec 7, 2019·Journal of Sleep Research·Erik HoffJan Hedner
Dec 24, 2019·Journal of Sleep Research·Marcus Vinícius F P SilvaRodrigo P Pedrosa
Feb 1, 2020·Journal of Hypertension·Dmitry M Davydov
Oct 17, 2018·Systematic Reviews·UNKNOWN VARIABLE BRAIN consortium
Dec 4, 2020·Cephalalgia : an International Journal of Headache·Sara SchrammSusanne Moebus
Nov 17, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Karen Ob AppiahThompson G Robinson
Apr 16, 2021·Translational and Clinical Pharmacology·Jihyun JungKyung-Sang Yu