MIGRAINE

A blood pressure drug can help reduce headache frequency.

* THE QUESTION Does candesartan cilexetil (Atacand) have any effect on migraine attacks?

* PAST STUDIES have shown that many people who experience frequent migraine attacks do not respond to the available medications.

* THIS STUDY examined the effects of candesartan cilexetil, a blood pressure medicine, on the frequency and severity of migraines. The researchers randomly assigned 60 people with two to six migraine attacks a month to receive either a daily dose of the drug for 12 weeks followed by 12 weeks of placebo, or 12 weeks of placebo first, followed by candesartan. On average, the patients had fewer days of headache (13.6) while taking candesartan than while taking the placebo (18.5). Also, the headaches they experienced were shorter and less severe while they were using the drug.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People experiencing frequent migraine attacks.

* CAVEATS AstraZeneca, the manufacturer of Atacand, was involved in the funding, design and preparation of the study. In addition, the results need to be verified in more people. Finally, the results are based on self-reports of frequency and severity of headaches.

* BOTTOM LINE People with frequent migraine attacks who do not respond to other medications may wish to consult their physician about using candesartan cilexetil.

* FIND THIS STUDY Jan. 1 issue of the Journal of the American Medical Association; abstract online at http://jama.ama-assn.org/.

STROKE

Blood pressure that is even slightly high can be dangerous.

* THE QUESTION Do small elevations in blood pressure pose health hazards?

* PAST STUDIES have shown that a systolic blood pressure of 160 or over is a risk factor for stroke among people over 65. A reading of 140 (the systolic pressure) over 90 (the diastolic pressure) is considered normal.

* THIS STUDY examined data from 12,344 participants. Of that total, 1,241 had borderline-high systolic blood pressure (140 to 159) at the beginning of the study, and 493 had higher readings. Of the total group studied, 825 had a stroke during a 20-year period. Those who entered the study with high systolic pressure were nearly three times more likely to have a stroke than those with normal pressure; those with borderline hypertension were one and a half times more likely to have a stroke. The researchers also found that these elevated risks applied equally to people aged 45 to 64 as to those aged 65 and over.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People with borderline-high blood pressure.

* CAVEATS The blood pressure of the participants may have varied during the study period.

* BOTTOM LINE People with borderline hypertension may wish to consult their physician about how lowering their blood pressure through diet and medication.

* FIND THIS STUDY December issue of Stroke; abstract online at http://stroke.ahajournals.org/current.shtml.

HEART DISEASE

Statins do not seem to interfere with a woman's fertility.

* THE QUESTION Do statins decrease women's reproductive hormones?

* PAST STUDIES have shown that statins safely reduce cholesterol levels. Researchers have theorized, however, that reduced levels of cholesterol may interfere with a woman's fertility by limiting the production of reproductive hormones.

* THIS STUDY analyzed reproductive hormones in 114 pre-menopausal women suspected of having an artery blocked by deposits of cholesterol. Overall, the 17 who took statins had levels of reproductive hormones similar to those of the 97 women who did not.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Pre-menopausal women who may wish to have children.

* CAVEATS The results are not based on a randomized trial. In addition, statin use was self-reported. Also, the results need to be verified in a larger group.

* BOTTOM LINE Pre-menopausal women with high cholesterol who may wish to have children may not need to worry about the effects of statin drugs on their fertility.

* FIND THIS STUDY December issue of the the American Journal of Medicine.

-- Haleh V. Samiei