A considerable proportion of patients discontinue dipyridamole therapy because of headache. Risk indicators for the development of dipyridamole induced headache were identified by means of an exploratory analysis of data from the European/Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT) and the Second European Stroke Prevention Study (ESPS 2). In ESPRIT, dipyridamole induced headache was significantly associated with female sex, absence of hypertension and non-smoking (area under the receiver operator characteristic (ROC) curve 0.63 (95% CI 0.58 to 0.68)) and in ESPS 2 with female sex and absence of ischaemic lesions on imaging (area under the ROC curve 0.64 (95% CI 0.59 to 0.69)).
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Competing interests: All authors were members of the Executive Committee of the ESPRIT trial. After completion, full analysis and publication of the efficacy study in ESPRIT, the executive committee accepted financial support from Boehringer Ingelheim for post hoc exploratory analyses of the ESPRIT trial data. These post hoc analyses pertain to the comparison of dipyridamole and aspirin versus aspirin alone; the Committee negotiated complete scientific freedom in the contract. There are no other competing interests.