A widely used medicine for high blood pressure and migraine prevention may offer another important health benefit for women.
A large new study suggests that propranolol, a medication that has been prescribed for decades, could lower the risk of ischemic stroke in women who experience migraines. The findings give hope that an affordable and well-known medicine may help prevent one of the most serious complications linked to migraine.
Migraines are much more than ordinary headaches. They can cause severe head pain, nausea, vomiting, and extreme sensitivity to light, sounds, and smells. Some people also experience an aura before a migraine begins.
An aura may include flashing lights, blurred vision, blind spots, tingling in the hands or face, or difficulty speaking. Around the world, migraines affect millions of people and are about three times more common in women than in men.
Over the past several years, research has shown that people with migraines, especially women, have a higher risk of stroke than people without migraines.
The greatest concern is ischemic stroke, which happens when a blood vessel supplying the brain becomes blocked. This is the most common type of stroke and can lead to permanent brain damage, disability, or death if blood flow is not restored quickly.
Although doctors know about the link between migraines and stroke, they have not been sure whether medicines used to prevent migraines could also reduce this risk. To answer this question, researchers analyzed more than three million electronic health records from two large medical databases in the United States.
The team identified people who had been diagnosed with migraines and compared those who later experienced an ischemic stroke with those who did not.
They also examined whether patients had been prescribed propranolol to prevent migraine attacks. The researchers analyzed women and men separately and also compared people with migraines that included aura with those without aura.
The results were encouraging. Women who took propranolol had a much lower risk of ischemic stroke than women who did not receive the medicine. In one database, the risk was reduced by 52%, while the second database showed a 39% reduction.
The strongest benefit appeared in women who had migraines without aura. In contrast, the researchers found no clear evidence that propranolol lowered stroke risk in men.
Propranolol belongs to a group of medicines called beta blockers. These medicines slow the heart rate and lower blood pressure by reducing the effects of stress hormones on the heart and blood vessels.
Doctors commonly prescribe propranolol for high blood pressure, irregular heart rhythms, chest pain, anxiety, and migraine prevention. Because it has been available for many years, it is generally much less expensive than many newer migraine treatments.
The researchers believe these findings could be especially important for women who have limited access to newer migraine medicines because of cost or availability.
Dr. Mulubrhan Mogos of Vanderbilt University School of Nursing, who led the study, said migraine is often overlooked as a risk factor for stroke in women. He suggested that affordable treatments such as propranolol may help reduce health inequalities by offering protection to more patients.
Dr. Tracy Madsen, a stroke specialist from the University of Vermont who was not involved in the research, described the results as promising.
She noted that beta blockers are already known to reduce stroke risk in people with high blood pressure, making the additional benefit seen in women with migraines particularly interesting. She also emphasized the importance of studying women and men separately because they may respond differently to treatments.
The researchers also pointed out several limitations. The study examined existing medical records rather than testing propranolol in a new clinical trial. This type of research cannot prove that the medicine directly prevented strokes.
Medical records may also contain errors or incomplete information, and other unknown factors may have influenced the results despite statistical adjustments.
Even with these limitations, the study provides strong evidence that propranolol deserves further investigation. Future clinical trials will be needed to confirm whether the medicine truly lowers stroke risk in women with migraines and to identify which patients benefit the most.
For now, women with migraines should not start or stop propranolol without speaking to their healthcare provider. Doctors can consider each person’s migraine pattern, stroke risk, blood pressure, and overall health before deciding whether propranolol is the right treatment.
The study offers encouraging evidence that a familiar and affordable medicine may one day help prevent not only painful migraine attacks but also serious strokes in many women.
If you care about stroke, please read studies about how to eat to prevent stroke, and diets high in flavonoids could help reduce stroke risk.
For more health information, please see recent studies about how Mediterranean diet could protect your brain health, and wild blueberries can benefit your heart and brain.
The findings were published in the journal Neurology.
