Migraine might be associated with
high blood pressure (BP), which can cause more severe and more difficult to treat forms of
headache. To evaluate the efficacy of
frovatriptan and other
triptans in the acute treatment of
migraine, in patients classified according to a history of arterial
hypertension, enrolled in three randomized, double-blind, crossover, Italian studies. Migraineurs with or without
aura were randomized to
frovatriptan 2.5 mg or
rizatriptan 10 mg (study 1),
frovatriptan 2.5 mg or
zolmitriptan 2.5 mg (study 2),
frovatriptan 2.5 mg or
almotriptan 12.5 mg (study 3). After treating up to three episodes of
migraine in 3 months with the first treatment, patients switched to the alternate treatment for the next 3 months. The present analysis assessed
triptan efficacy in 60 subjects with a history of treated or untreated essential arterial
hypertension (HT) and in 286 normotensive (NT) subjects. During the study,
migraine attacks with
aura were significantly more prevalent in HT subjects (21 vs. 13 % NT, p < 0.001). The proportion of
pain free at 2 h did not significantly differ between HTs and NTs for either
frovatriptan (25 vs. 26 %) or the comparators (33 vs. 32 %).
Pain relief was achieved in significantly (p < 0.05) fewer episodes in HT subjects for both
frovatriptan (41 vs. 52 % NT) and the comparators (48 vs. 58 %). Relapses at 48 h were similarly low in HTs and NTs with
frovatriptan (29 vs. 31 %), while they were significantly (p < 0.05) larger in HTs (62 %) than in NTs (44 %) with comparators.
No BP or heart rate increment was observed during the study in HT subjects. No difference in tolerability was reported between HTs and NTs. In conclusion, HT individuals tend to be less responsive than NT migraineurs to
triptan therapy. However,
frovatriptan, in contrast to other
triptans, seems to have a sustained antimigraine effect in both HT and NT patients.