Framingham Risk Stratification of Middle-Aged Migraineurs

Abstract

Introduction. Migraine is a common primary headache disorder involving about 10-15% of the whole population. Several epidemiological and prospective studies showed a link between migraine (especially migraine with aura) and cardio- and cerebrovascular events. Objectives. We prospectively analyzed the data of vascular event-free middle-aged patients with migraine who were referred to our Headache Clinic between 01/2014 and 01/2018. Framingham 10-year risk were calculated; covariates included in the analysis were age, total cholesterol, HDL cholesterol, systolic blood pressure, antihypertensive medication use, current smoking, and diabetes status. Results. Total of 1037 patients were screened and 221 were selected, 161 were women (mean age 55.5±5.2 years) and 60 were men (mean age 56±6 years). 25 patients (11.3%) were labelled as having low risk, 162 patients (73.3%) had moderate risk, and 34 patients (15.4%) had high or very high risk. Blood pressure and lipid targets were reached in 73% and in 49% in the moderate risk and in 53% and 12% in the high risk/very high risk groups, respectively. Migraine with aura (MA) was associated significantly higher cardiovascular risk profile compared with migraine without aura (MO). About one-third of our nondiabetic patients had fasting blood glucose above the normal levels. 24 patients (mean age 60±4.9 years) were diabetic. Mean blood pressure was 149/85 Hgmm, mean choleterol was 5.11 mmol/l, and mean LDL was 2.93 mmol/l in this subgroup, respectively, which do not fall within the recommended targets. Conclusion. Our article draws attention to the higher cardiovascular risk profile of middle-aged migraineurs and highlights the deficiency of primary prevention. Pain physicians must be aware of the cardiovascular aspects of migraine and holistic approach is required instead of focusing only on pain and pain relief.

Vascular Risk Score and Associations With Past, Current, or Future Migraine in Women

“…Prior studies on the relationship between vascular risk, as operationalized by the FRS or by one of its vascular risk factor components, and migraine status have shown conflicting results. Although some studies reported increased FRS among those with migraine, 28,29 another study reported a decreased risk in the hypertension component of the FRS among those with migraine compared with those without migraine. 30 Yet other studies reported increased risk of developing hypertension among women with migraine.…”

Headache in the Workplace: Analysis of Factors Influencing Headaches in Terms of Productivity and Health

“…Epidemiological and clinical considerations demonstrate that obesity increases morbidity in migraine and headache, whereas weight loss can improve headache morbidity [ 70 ]. The association between migraine and dyslipidemia has been observed in case-control [ 71 ] and population studies [ 72 ].…”