In a new study, researchers found new migraine drugs could block αCGRP, a neuropeptide that causes vasodilation, for example in the meninges.
The very same neuropeptide, which is formed in the muscles during physical activity, protects the heart—which is vital for people with chronic high blood pressure.
This means the new migraine drugs prophylaxis could endanger these people.
The research was conducted by a team at the University of Zurich.
The neuropeptide αCGRP (α calcitonin gene-related peptide) works in two different ways.
It leads to inflammation and dilates the blood vessels right at the release point of the nerve cells, for example in the meninges, which can trigger migraine attacks.
However, it has a completely different effect on the heart.
αCGRP is also released from active skeletal muscles. It is transported via the blood from the muscle to the heart where it inhibits the pathological heart problems caused by high blood pressure.
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.
In the study, the team found that having normal levels of αCGRP in the blood 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.
The team also found that long-term use of αCGRP blockers for migraine in mice with chronic high blood pressure resulted in life-threatening cardiac dysfunction.
Medications of this kind, which take a targeted approach to block the neuropeptide, have recently been approved for migraine prophylaxis.
The researchers say caution is required with migraine medications and chronic high blood pressure.
In the future, drugs that activate the release of αCGRP or mimic its action could be used in high blood pressure patients who can only be physically active to a very limited extent or in whom antihypertensive medications have little or no effect.
The lead author of the study is Johannes Vogel, professor at the UZH Institute of Veterinary Physiology.
The study is published in Circulation Research.
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