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Angiotensin antagonists and headache prevention

Clinical bottom line

Angiotensin II receptor antagonists reduce headache incidence by a modest amount.


Background

There have been observations that headaches occur less frequently with angiotensin II receptor antagonists.

Systematic review

There was a systematic search for randomised trials of any angiotensin II receptor antagonist compared with placebo, and for trials of headache. For inclusion trial duration had to be at least one week, with patients taking no other antihypertensive medicine.

Reference

M Etminan et al. Efficacy of angiotensin II receptor antagonists in preventing headache: a systematic overview and meta-analysis. American Journal of Medicine 2002 112: 642-646.

Results

The risk of headache was about one third (31%) lower with angiotensin II receptor antagonists than with placebo (pooled relative risk 0.69 (95%CI 0.62 to 0.76). In a more detailed analysis of seven irbesartan trials [1] indicated that factors predictive of headache were diastolic blood pressure, female sex, and age above 50 years.

Comment

Angiotensin II receptor antagonists reduce headache incidence by a modest amount.

References:

  1. L Hansson et al. Headache in mild-to-moderate hypertension and its reduction by Irbesartan therapy. Archives of Internal Medicine 2000 160: 1654-1658.