New Migraine Medications Not Good for People with High Blood Pressure

New migraine medications target the neuropeptide αCGRP (α calcitonin gene-related peptide), which works in two different ways. Frist, it causes inflammation and dilates the blood vessels, which can trigger migraine attacks. Second, it has a completely different effect on the heart, as has now been discovered by researchers at the University of Zurich (UZH).

Good for the heart

The researchers studied the neuropeptide in mice.  αCGRP is released from active skeletal muscles. It is transported through blood from the muscle to the heart where it inhibits the problems caused by chronic high blood pressure. “It is exactly the same for humans as it is for mice,” says study leader Johannes Vogel, professor at the UZH Institute of Veterinary Physiology. “Physical activity and sport increase the blood plasma levels of αCGRP, which has a positive effect on the heart in patients with high blood pressure.”

Treatment option for some people with high blood pressure

The research involved comparing normal mice with others having chronic high blood pressure, which were either sedentary or repeatedly and voluntarily ran in a running wheel. The study revealed that having normal concentrations of αCGRP in the blood plasma is vital and that the peptide is crucial for the positive effects of physical activity on the heart. αCGRP also provides the heart with extra protection, regardless of its antihypertensive properties in high doses. “In the future, substances that activate the release of αCGRP or mimic its action could be used in hypertensive patients who can only be physically active to a very limited extent or in whom antihypertensive medications have little or no effect,” explains Johannes Vogel.

Caution required with migraine medications and chronic high blood pressure

The research work also brought another finding to light – long-term administration of αCGRP blockers in mice with chronic high blood pressure resulted in life-threatening cardiac dysfunction. Medications of this kind, which take a targeted approach to blocking the neuropeptide, have recently been approved for migraine prophylaxis. As the neuropeptide αCGRP in species from zebrafish to humans is very similar, it must be part of a key biological mechanism that works in the same way in different organisms. According to cardiovascular specialist Vogel, the results are therefore also relevant to humans: “αCGRP blockers should only be used for migraine prevention with the proviso that patients’ blood pressure is monitored regularly. Chronic high blood pressure should be added to the list of contraindications for the long-term use of αCGRP blockers.”

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