Migraine and cardiovascular disease

Abstract

Objectives: Although the relationship between migraine and cardiovascular disease (CVD) has been studied, several questions remain unanswered. Herein we contrast the rate of diagnosed CVD as well as of risk factors for CVD in individuals with migraine with and without aura (MA and MO) and in controls. Methods:In this case-control study, migraineurs (n ϭ 6,102) and controls (n ϭ 5,243) were representative of the adult US population. Headache diagnosis was formally assigned using a validated mailed questionnaire which also obtained details on treatment, comorbidities, and other variables. CVD events were obtained based on self-reported medical diagnosis. Risk factors for CVD and modified Framingham scores were computed. Results:In unadjusted analyses, migraine overall and MA were associated with myocardial infarction, stroke, and claudication, and MO was associated with myocardial infarction and claudication. Migraineurs were more likely than controls to have a medical diagnosis of diabetes (12.6% vs 9.4%, odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2-1.6), hypertension (33.1% vs 27.5%, OR 1.4, 95% CI 1.3-1.6), and high cholesterol (32.7% vs 25.6%, OR 1.4, 95% CI 1.3-1.5). Risk was highest in MA, but remained elevated in MO. Framingham scores were significantly higher in MO and MA than in controls. After adjustments (gender, age, disability, treatment, CVD risk factors), migraine remained significantly associated with myocardial infarction (OR 2.2, 95% CI 1.7-2.8), stroke (OR 1.5, 95% CI 1.2-2.1), and claudication (OR 2.69, 95% CI 1.98 -3.23). Conclusion:Both migraine with and without aura are associated with cardiovascular disease (CVD) and with risk factors for CVD. However, since our sample size is large, the clinical relevance of the differences is yet to be established. Neurology ® 2010;74:628 -635

Latin American consensus on guidelines for chronic migraine treatment

“…Migraine, especially the one with aura, is associated with greater incidence of myocardial infarction and vascular claudication 26 . There is no data in the literature showing the association between cardiovascular diseases and chronic migraine.…”

Hypertension and Migraine in the Northern Manhattan Study

“…1,2 Individuals with migraine, particularly migraine with aura, are at risk for both ischemic and hemorrhagic forms of stroke, ischemic heart disease, myocardial infarction, angina, coronary revascularization procedures, and vascular mortality. 3 Individuals with migraine have an adverse cardiovascular risk profile, including hypertension.…”

Diffusion-weighted lesions in acute ischaemic stroke patients with migraine

“…Patients with migraine seem especially prone to posterior circulation infarctions (5,6). In later years, data suggesting an association between migraine, cardiovascular and peripheral vascular disease have also been published; however, the significance of these associations needs to be investigated further before any conclusions can be drawn (7)(8)(9)(10).…”