Propranolol May Cut Stroke Risk in Women With Migraine

For patients with migraine, the clinical benefits of propranolol, a beta blocker medication, may extend beyond just migraine prophylaxis, according to a study to be presented at the American Stroke Association’s International Stroke Conference 2025. 

Researchers from Vanderbilt University conducted a retrospective case-control study to assess the potential protective effects of propranolol, a medication widely used for migraine prevention, using electronic health records from 2 large databases (Synthetic Derivative [SD] at Vanderbilt University Medical Center and the All of Us Research Program managed by the National Institutes of Health). 

Across these databases, they identified cases (378 in SD and 267 in All of Us), defined as patients with a primary diagnosis of stroke following the first onset of migraine, and controls (15,209 in SD and 6579 in All of Us), defined as those with no stroke diagnosis after first migraine onset. Propranolol use and stroke risk were evaluated at 4 timepoints over a 10-year period.

After adjusting for potential confounders (age, sex, race, use of birth control, pregnancy), findings showed propranolol use was associated with a significant reduction in the risk of  stroke among female migraine patients (SD odds ratio [OR], 0.52; P =.006; All of Us OR, 0.39; P =.007); the same effect was not seen in male patients. 

This protective effect was found to be more pronounced in women with migraines without aura and for ischemic stroke. Overall, the analysis showed lower stroke rates among female propranolol users at multiple timepoints. 

“Our findings indicate that women and healthcare professionals should discuss the advantages of preventive migraine interventions,” said lead study author Mulubrhan Mogos, PhD, MSc, FAHA, an assistant professor at Vanderbilt University School of Nursing in Nashville, Tennessee. “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.”

This article originally appeared on MPR