Calcitonin gene-related peptide (CGRP) monoclonal antibodies increase blood pressure (BP) among patients taking the therapy for migraine prevention, according to findings published in Neurology. Gisela Terwindt, MD, PhD, and colleagues examined all patients with migraine who received erenumab and fremanezumab at a single headache center between January 2019 and January 2021, obtaining BP measurements from baseline (T0) through 12months, with a 3-month interval (T1-T4). Both systolic and diastolic BP were higher at all time points (T1-T4) compared with T0 (P<0.001). The maximum estimated increase in mean systolic BP was 5.2 mmHg (95% CI, 3.1-7.5); the maximum estimated increase in mean diastolic BP was 3.5 mmHg (95% CI, 2.0- 4.9). For patients treated with erenumab (N=109), both systolic and diastolic BP were higher at all time points compared with T0 (all P<0.001); for freman ezumab (N=87), systolic but not diastolic BP was higher, compared with T0, at T1 (P=0.006) and T2 (P=0.004). “The majority of patients remained within the normal [BP] limits, but some patients required antihypertensive treatment,” Dr. Terwindt and colleagues wrote. “Physicians should be aware that people with migraine may be at risk [for developing] hypertension when treated with anti-CGRP (receptor) antibodies.”
