In migraine patients, especially those who have migraines with aura, pharmacists should emphasize identification and treatment of modifiable vascular risk factors, such as smoking, hypertension, diabetes, and hypercholesterolemia.
While positive outcomes with drugs and treatments require prompt intervention, ideally at the first sign of distress, about one-third of women do not experience chest pain when having a heart attack.
In older age groups, men are affected more often and the disease is often misdiagnosed. Triggers include medications such as antibiotics, beta-blockers, and statins.
Among the most frequently prescribed medications, PPIs are associated with an increased risk of fracture, Clostridium difficile infection, community-acquired pneumonia, and vitamin and mineral deficiencies.
A prior history of anxiety, depression, and physical and psychological trauma is significantly predictive of onset of chronic pain in later life. The risk of central sensitization should not be underestimated.