Beta-Blocker Shows Promise in Reducing Stroke Risk for Women with Migraine

Treatment with propranolol for women with migraine may reduce risk of stroke, according to findings from a preliminary study of 3 million electronic health records (EHRs) presented at the American Stroke Association’s International Stroke Conference 2025. Propranolol, a nonselective beta-blocker prescribed to treat hypertension and prevent migraines, was shown to be effective in reducing ischemic stroke risk in women who experience migraines without aura. A similar protective effect was not demonstrated in male patients.

The case-control study included data from the Synthetic Derivative (SD) database of the Vanderbilt University Medical Center, as well as the All of Us Research Program database of the National Institutes of Health (NIH). Using International Classification of Diseases codes (ICD 9 and 10), researchers identified migraine patients with and without subsequent stroke diagnoses. Patients without a stroke diagnosis comprised the control group. A total of 378 stroke cases and 15,209 control patients were identified in the SD database, with 267 cases and 6,579 control patients in the All of Us database.

Logistic regression models adjusted for confounding variables were used to assess the association between propranolol use and stroke risk, with the following key findings:

• Propranolol treatment significantly reduced overall stroke risk in female migraine patients in both the SD database (odds ratio [OR], 0.52; P=.006) and the All of Us database (OR, 0.39; P=.007).
• Propranolol’s protective effect was more robust in those with ischemic stroke and in women with migraine without aura.
• Treatment with propranolol was not shown to reduce stroke risk in men.
• Cumulative incidence analyses demonstrated lower stroke rates in propranolol-treated female patients at multiple time points within both databases.

“Our findings indicate that women and health care professionals should discuss the advantages of preventive migraine interventions,” said Mulubrhan Mogos, PhD, MSc, FAHA, Assistant Professor, Vanderbilt University School of Nursing and lead study author. “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.”