Ankle‐Brachial Index, a Screening for Peripheral Obstructive Arterial Disease, and Migraine – A Controlled Study

Jurno, Mauro Eduardo; Chevtchouk, Liliana; Nunes, Aida Aguilar; Rezende, Dilermando Fazito de; Jevoux, Carla; Souza, Jano Alves de; Filho, Pedro Ferreira Moreira

doi:10.1111/j.1526-4610.2009.01536.x

Cited by 17 publications

(23 citation statements)

References 17 publications

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“…As compared with oscillometric ABI, sensitivity and specificity of Doppler ABI (<0.9) were higher 2 . Mean age was 42.1 (8.4) years in our migraineurs and 36 (9.9) years of participants in the study of Jurno et al 1 . Methodological differences of ABI measurement and age of migraineurs may lead to diverse results between 2 studies.…”

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confidence: 62%

“…There were no significant differences of ABI values between among 4 groups of migraine, MA, MO sufferers and controls on multivariate logistic regression analysis adjusted by age, sex, and several CVD risk factors. Jurno et al 1 disclosed mean ABI (SD) of 0.94 (0.11) in 50 migraineurs and 0.99 (0.09) in 38 controls. ABI values <0.9 was found in 24 migraineurs (48%) and 7 controls (18%).…”

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confidence: 97%

“…We read the article by Jurno et al 1 with great interest. Authors conducted a significant reduction of ankle‐brachial index (ABI) in migraineurs 1 . As compared with our data of ABI in migraineurs on physical check‐up, we would like to comment on conclusions of Jurno et al.…”

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confidence: 99%

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Ankle‐Brachial Index in Migraineurs

et al. 2010

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Ankle-Brachial Index in Migraineursh ead_1702 1215..1221To the editor:We read the article by Jurno et al 1 with great interest. Authors conducted a significant reduction of ankle-brachial index (ABI) in migraineurs. 1 As compared with our data of ABI in migraineurs on physical check-up, we would like to comment on conclusions of Jurno et al.Oscillometric ABI was measured in 123 migraineurs (22 with aura [MA] and 101 without aura [MO]) and 118 controls. Female ratio was 80% in both groups. Mean age (SD) was 42.1 (8.4) years in migraineurs and 42.7 (9.5) years in controls. Cardiovascular disease (CVD) risk profile of migraineurs suggested 6 subjects in hypertension, 3 in diabetes mellitus, 13 in dyslipidemia, 18 in current smoking, and 14 in obesity. Only 1 woman with MO had ABI values lower than 0.9. Her age was 29 years and no CVD risk factors existed. Mean ABI (SD) was 1.05 (0.06) in migraineurs and 1.06 (0.07) in controls. There were no significant differences of ABI values between among 4 groups of migraine, MA, MO sufferers and controls on multivariate logistic regression analysis adjusted by age, sex, and several CVD risk factors. Jurno et al 1 disclosed mean ABI (SD) of 0.94 (0.11) in 50 migraineurs and 0.99 (0.09) in 38 controls. ABI values <0.9 was found in 24 migraineurs (48%) and 7 controls (18%). Using logistical regression, odds ratio of ABI <0.9 was 3.9 in the migraine group. We would like to know the age and CVD risk profile in migraineurs and controls with decreased ABI. Arterial pressure was obtained with an ultrasonic Doppler device whereas we measured oscillometric ABI. As compared with oscillometric ABI, sensitivity and specificity of Doppler ABI (<0.9) were higher. 2 Mean age was 42.1 (8.4) years in our migraineurs and 36 (9.9) years of participants in the study of Jurno et al. 1 Methodological differences of ABI measurement and age of migraineurs may lead to diverse results between 2 studies. Authors provide the possibility that existence of migraine contributes to lower ABI. 1 Age distribution of migraineurs is suggested to peak from 20 to 50 years of age. Finally, long-term monitoring of ABI is needed whether atherosclerotic changes influence abnormal ABI in young or midlife migraineurs. We speculate that ABI abnormalities could play a crucial role in the dysregulation of vascular reactions in a part of migraineurs, rather than CVD risk or peripheral obstructive arterial disease.

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Ankle‐Brachial Index in Migraineurs

et al. 2010

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“…However, in migraineurs the evidence of an atherothrombotic mechanism leading to vascular events is not supported and much evidence points against this possibility. [53,54] In fact, intima-media thickness (IMT), which is a surrogate marker of subclinical atherosclerosis has not been consistently linked to migraine status [20,24,27,55,56]. In addition, despite little information being available on the frequency of the different subtypes of ischemic stroke in migraineurs, the available studies do not support an increased atherosclerotic load [57,58].…”

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confidence: 99%

Peripheral vascular dysfunction in migraine: a review

et al. 2013

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Numerous studies have indicated an increased risk of vascular disease among migraineurs. Alterations in endothelial and arterial function, which predispose to atherosclerosis and cardiovascular diseases, have been suggested as an important link between migraine and vascular disease. However, the available evidence is inconsistent. We aimed to review and summarize the published evidence about the peripheral vascular dysfunction of migraineurs.We systematically searched in BIOSIS, the Cochrane database, Embase, Google scholar, ISI Web of Science, and Medline to identify articles, published up to April 2013, evaluating the endothelial and arterial function of migraineurs.Several lines of evidence for vascular dysfunction were reported in migraineurs. Findings regarding endothelial function are particularly controversial since studies variously indicated the presence of endothelial dysfunction in migraineurs, the absence of any difference in endothelial function between migraineurs and non-migraineurs, and even an enhanced endothelial function in migraineurs. Reports on arterial function are more consistent and suggest that functional properties of large arteries are altered in migraineurs.Peripheral vascular function, particularly arterial function, is a promising non-invasive indicator of the vascular health of subjects with migraine. However, further targeted research is needed to understand whether altered arterial function explains the increased risk of vascular disease among patients with migraine.

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“…Moreover, the potency for 5-HT found in our study for proximal segment in the femoral artery (6.86) was closely related to those obtained in the basilar artery (6.88) indicating that both preparations present great similarities in pharmacologic properties. Interestingly, clinical evidences have shown that PAD is more common in migraineurs than in controls 24,25 . Altogether, our data showed that femoral artery is an interestingly model to study serotoninergic receptor signaling pathway under normal and pathological conditions such as diabetes mellitus and atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%