Hypertension has been identified as one of the most important factors of chronic transformation of episodic migraine and increases the cerebrovascular and cardiovascular risk of migraine patients. Migraine and arterial hypertension may share common mechanisms like endothelial dysfunction, deficiency of autonomic cardiovascular regulation and renin angiotensin system involvement. Preventive effects of migraine were described by several antihypertensive agents traditionally beta-blockers. (Finocchi & Sassos, 2017)
There are several options available for preventing migraines including alpha antagonists, antiepileptics, beta-blockers, botulinum toxin-A, calcium channel blockers, serotonin agonists, serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). Propranolol reduces headaches by more than 50% as well as reducing the number of analgesic medication doses required. It also reduces the severity or duration of the headaches experienced. (Jackson et al, 2019) Preventive therapy is used to try to reduce the frequency, duration, or severity of attacks. The preventive medications with the best-documented efficacy are amitriptyline, divalproex, topiramate, and the beta-blockers. (Silberstein, 2009)
Finocchi C, Sassos D. Headache and arterial hypertension. Neurol Sci. 2017 May;38(Suppl 1):67-72. doi: 10.1007/s10072-017-2893-x. PMID: 28527058.
Jackson JL, Kuriyama A, Kuwatsuka Y, Nickoloff S, Storch D, Jackson W, Zhang ZJ, Hayashino Y. Beta-blockers for the prevention of headache in adults, a systematic review and meta-analysis. PLoS One. 2019 Mar 20;14(3):e0212785. doi: 10.1371/journal.pone.0212785. PMID: 30893319; PMCID: PMC6426199.
Silberstein SD. Preventive migraine treatment. Neurol Clin. 2009 May;27(2):429-43. doi: 10.1016/j.ncl.2008.11.007. PMID: 19289224.