Which condition must be excluded before treating a patient with triptans for migraines?

When considering the treatment of migraines with triptans, it is essential to exclude cardiovascular disease. This is because triptans are vasoconstrictors, and their use can potentially trigger serious cardiovascular events, particularly in individuals with pre-existing cardiovascular conditions such as coronary artery disease or uncontrolled hypertension. Since triptans can increase blood pressure and cause myocardial ischemia, assessing a patient's cardiovascular health before prescribing these medications is critical to avoid severe complications.

While hypotension, diabetes, and allergic reactions are important clinical considerations, they do not carry the same immediate risk of serious complications associated with triptan use. Hypotension, for example, can lead to dizziness or fainting but is less likely to result in acute life-threatening scenarios as compared to the potential for a cardiovascular event in patients with underlying heart disease. Therefore, prior evaluation and management of cardiovascular risk factors are paramount when considering triptans for migraine therapy.