Migraine and Markers of Carotid Atherosclerosis in Middle‐Aged Women: A Cross‐Sectional Study

Abstract

Objective This study evaluated the association between migraine and the markers of carotid artery disease. Background Migraine increases the risk of cardiovascular events, but its relationship with vascular dysfunction is unclear. Methods In this cross‐sectional study, middle‐aged women with no known cardiovascular diseases underwent clinical, neurological, and laboratory evaluations; pulse wave velocity (PWV) assessment; and carotid artery ultrasonography. We divided the participants based on the presence of migraine and, further, based on the type of migraine. Associations between migraine and carotid thickening (intima‐media thickness >0.9 mm), carotid plaques, or arterial stiffening (PWV >10 m/s) were evaluated using a multiple regression analysis. Results The study comprised 112/277 (40%) women with migraine, of whom 46/277 (17%) reported having an aura. Compared to the non‐migraineurs, the migraine with aura group had an increased risk of diffuse carotid thickening (3/46 [6.8%] vs 2/165 [1.3%], adjusted OR = 7.12, 95% CI 1.05–48.49). Migraine without aura was associated with a low risk of carotid plaques (3/66 [4.7%] vs 26/165 [16.7%], adjusted OR = 0.28, 95% CI 0.08–0.99) and arterial stiffening (21/66 [34.4%] vs 82/165 [51.2%], adjusted OR = 0.39, 95% CI 0.19–0.79). There were no correlations between migraine characteristics and arterial stiffness or carotid thickness measurements. Conclusion Migraine with aura is associated with an increased risk of carotid thickening, and migraine without aura is associated with a low risk of carotid plaques and arterial stiffening.

Migraine and Ischemic Stroke in Women. A Narrative Review

“…In migraineurs with subclinical infarction in the CAMERA study, the clinical and radiological features of the multiple, small lesions found predominantly in the deep arterial border zone of the cerebellum suggested hypoperfusion or embolism rather than atherosclerosis 38 . In contrast, there are 7 studies reporting evidence of subclinical atherosclerosis in adults with migraine, 136‐142 including in those with episodic migraine and those with aura 136‐139 . One recent study also reported an independent association of carotid wall thickening with triptan and ergotamine consumption, suggesting that repeated use of these vasoconstrictive agents may have lasting effects 137 .…”

Migraine and large artery atherosclerosis in young adults with ischemic stroke

“…Additional causes of stroke that may be involved in migraine include enhanced cortical spreading depolarization, endothelial dysfunction, vasospasm, and coagulopathy 1 . On the other hand, arguments for a lower susceptibility to LAA in migraine are: the persistence of a strong negative association between migraine and LAA after adjustment for vascular risk factors in our study; and the results of studies in the general population that have shown less arterial calcification in the intracranial carotid artery 19 and less plaque in the extracranial carotid artery, 20 or a less pronounced tendency for extracranial carotid atherosclerosis in people with migraine than people without migraine 21 . Moreover, genome‐wide association studies have identified a single mononucleotide polymorphism of the gene PHACTR1 shared by both migraine and coronary artery disease but in an opposite direction, that is, the migraine‐associated variant was negatively associated with coronary artery disease 22,23 …”

Associations between migraine occurrence and the effect of aura, age at onset, family history, and sex: A cross-sectional study

“…In future, we will take this into consideration and exclude these confounding factors. Third, recent studies have suggested that migraine with aura is associated with an increased risk of carotid thickening, whereas migraine without aura is associated with a low risk of carotid plaques and arterial stiffening [52]. In the present study, we did not evaluate the relationship between migraine and the markers of vascular damage.…”