Propranolol May Lower Stroke Risk in Women with Migraine, Study Finds
Data set to be presented at ISC 2025 shows that the protective effect of propranolol was stronger for ischemic stroke compared to other stroke types.
©9nong/AdobeStock
A new retrospective case-control study suggests that propranolol, a commonly used beta-blocker for migraine prevention, may also reduce the risk of stroke in women with migraine.1
The analysis, based on 2 large electronic health record databases, found a significant association between propranolol use and lower stroke incidence among women with migraines.1
The findings will be presented at the upcoming American Stroke Association’s (AHA) International Stroke Conference 2025, being held February 5-7 in Los Angeles, California.
Researchers analyzed data from the Synthetic Derivative (SD) at Vanderbilt University Medical Center and the All of Us Research Program. The study included 378 stroke cases and 15 209 controls from the SD database, and 267 cases with 6579 controls from the All of Us database.1
Logistic regression models adjusted for confounders revealed that propranolol use was linked to a reduced overall stroke risk in women with migraine (SD: OR = 0.52, P = 0.006; All of Us: OR = 0.39, P = 0.007), with a stronger protective effect for ischemic stroke and migraines without aura. However, no significant association was found in men.1
Cumulative incidence analyses showed consistently lower stroke rates at multiple time points in propranolol-treated women across both databases. The study authors suggest that propranolol may offer dual benefits for migraine management and stroke prevention in high-risk populations.1
Lead study author Mulubrhan Mogos, PhD, MSc, an assistant professor at Vanderbilt University School of Nursing, emphasized the importance of this finding in an AHA press release, stating, “Migraine is an often-ignored risk factor for cardiovascular issues. Many women suffer from migraines, and it’s important to note that propranolol may be beneficial for these women, particularly those who experience migraine without aura. This is an important discovery for those dealing with migraines.”2
The study also sheds light on health disparities related to migraine treatment. Mogos noted that women from historically under-resourced communities face greater barriers to accessing effective treatments, which may impact their overall health and socioeconomic stability. “For under-resourced individuals who bear a greater burden from this condition and may lack access to new treatments, we must ensure these treatments are available to them. This approach can help reduce health disparities,” Mogos added.2
Tracy E. Madsen, MD, PhD, chair of the American Heart Association Clinical Cardiology/Stroke Women’s Health Science Committee, commented on the findings, stating, “Migraine without aura may often be overlooked as a risk factor for stroke, especially in women, in whom previous literature has demonstrated that migraine is a stronger, more important risk factor compared with men. The study’s findings are not surprising since we have strong evidence that medications similar to propranolol used to treat blood pressure reduce stroke risk substantially. The findings are potentially quite helpful, though, for women living with frequent migraine, as they suggest we have a good medication option that helps to prevent both migraines and strokes."2
Madsen, who was not an investigator for this study, continued2:
"This study is a great example of the important information that can be gained by studying women and men separately – we can take advantage of known sex differences in stroke risk factors and move towards more personalized care."
Despite these promising results, researchers acknowledge limitations in their study, including the reliance on retrospective data and potential biases from electronic health records. They stress the need for prospective clinical trials to validate these findings and better inform treatment guidelines.2
“These findings suggest that propranolol may be beneficial not only for migraine prophylaxis but also for stroke prevention in high-risk populations. Further prospective studies are warranted to validate these results and inform clinical guidelines,” Mogos and colleagues concluded in the study abstract.1
References:
1. Jeong E, Chen Y, Mogos MF. Propranolol's potential role in cutting stroke risk for patients with migraine: An in-depth analysis of two databases. Abstract presented at: American Heart Association International Stroke Conference 2025; February 5-7, 2025; Los Angeles, California.
2. Propranolol may reduce ischemic stroke risk in women with migraines. News release. American Heart Association. January 30, 2025. Accessed January 31, 2025. https://newsroom.heart.org/news/propranolol-may-reduce-ischemic-stroke-risk-in-women-with-migraines
