Which condition, if present, may be a contraindication to sumatriptan therapy?

• A. Cardiovascular disease
• B. Hypertension
• C. Diabetes
• D. Migraine

Answer: (A)

Sumatriptan works by activating 5-HT1B/1D receptors to constrict cranial blood vessels, which helps relieve migraine symptoms. That vasoconstrictive effect can reduce blood flow to the heart or brain in people with cardiovascular disease, potentially triggering ischemia or arrhythmias. Because of this risk, cardiovascular disease is a contraindication to sumatriptan. Hypertension, diabetes, and migraine themselves don’t inherently prohibit use in the same way; hypertension isn’t an absolute contraindication in all cases, diabetes isn’t a contraindication, and migraine is the condition being treated. When cardiovascular disease is present, alternatives that don’t rely on vasoconstriction are preferred.