Migraine and other headaches

Rose, Kathryn M.; Carson, April P.; Sanford, Catherine P.; Stang, Paul; Brown, C. Andrew; Folsom, Aaron R.; Szklo, Moysés

doi:10.1212/01.wnl.0000147289.50605.dc

“…Due to the association between migraine (mostly MA) and ischemic stroke, it is of interest whether migraine is similarly associated with coronary heart disease as well. Although some studies yielded negative or conflicting results for overall migraine, 39 case reports 40 and large-scale cohort studies 9 found an association between migraine and chest pain. In some cases, migraine was associated with ischemic electrocardiographic changes.…”

Section: Shared Risk Factors and Shared Co-morbidities: Migraine And mentioning

confidence: 99%

Migraine and cardiovascular disease

Bigal¹,

Kurth

²

,

Hu³

et al. 2009

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Migraine, especially migraine with aura (MA), is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication, and cardiovascular mortality. The mechanisms which link migraine to ischemic vascular disease remain uncertain and are likely to be complex. Cortical spreading depression, the presumed substrate of aura, may directly predispose to brain lesions and that would explain why MA is consistently demonstrated as a risk factor for cerebral ischemia, while for migraine without aura (MO), the evidence is less consistent. Additionally, individuals with migraine have a higher prevalence of risk factors known to be associated with cardiovascular disease (CVD), including hypertension, diabetes, and hyperlipidemia. The increased prevalence of CVD risk factors is also higher for MA than for MO. Since the evidence linking migraine and CVD is getting robust, neurologists should be aware of this association. Individuals with MO seem to be at little increased risk of CVD. MA is associated with an increased risk of ischemic stroke and likely also for other ischemic CVD events. Accordingly, heightened vigilance is recommended for modifiable cardiovascular risk factors in migraineurs, especially with MA. Ultimately, it will be important to determine whether MA is a modifiable risk factor for CVD and if preventive medications for migraine or antiplatelet therapy might reduce the risk of CVD in patients with MA. Neurology ® 2009;72:1864-1871 GLOSSARY BMI ϭ body mass index; CDH ϭ chronic daily headache; CI ϭ confidence interval; CSD ϭ cortical spreading depression; CVD ϭ cardiovascular disease; EPC ϭ endothelial progenitor cells; HR ϭ hazard ratio; MA ϭ migraine with aura; MMP ϭ matrix metalloproteinase; MO ϭ migraine without aura; MTHFR ϭ methyltetrahydrofolate reductase; RR ϭ relative risk.

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“…Population studies support the relationship between migraine, specially MA, and coronary disease. In the Atherosclerosis Risk in Communities study 37 , patients with headache were roughly twice as likely to have a history of angina, as compared to controls, with the risk most elevated in the headache group with aura.…”

Section: Mechanisms Of Association Putative Mechanisms Commentsmentioning

confidence: 97%

“…Migraine and coronary heart disease Although some studies yielded negative or conflicting results for the overall association of migraine and coronary heart disease 35 , other studies reported a positive association and even electrocardiographic changes experienced by migraineurs [36][37][38] . Population studies support the relationship between migraine, specially MA, and coronary disease.…”

Section: Mechanisms Of Association Putative Mechanisms Commentsmentioning

confidence: 99%

Migraine and cardiovascular disease

Bigal

¹

2011

Arq. Neuro-Psiquiatr.

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Migraine, especially migraine with aura is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine with and without aura to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication and cardiovascular mortality. The topic is therefore of considerable interest. Accordingly, herein we review the association between migraine and cardiovascular disease. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis. Key words: migraine, cardiovascular disease, stroke. Migrânea e doenças cardiovasculares RESUMOA migrânea, especialmente a migrânea com aura, é fator de risco para lesões cerebrais. Evidência recente sugere que migrânea com e sem aura é associada com outras doenças cardiovasculares isquêmicas, incluindo a angina, o infarto do miocárdio, revascularização coronária, claudicação e morte súbita. Iniciamos discutindo o diagnóstico da migrânea e seus mecanismos fisiopatológicos. Após sumarizar a evidência, discutimos resultados de meta-análise recente. Por fim, ressaltamos resultados de um grande estudo populacional sobre o assunto. Palavras-chave: migrânea, doença cardiovascular, acidente vascular cerebral.

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“…In the Atherosclerosis Risk in Communities study 37 , patients with headache were roughly twice as likely to have a history of angina, as compared to controls, with the risk most elevated in the headache group with aura.…”

Section: Mechanisms Of Association Putative Mechanisms Commentsmentioning

confidence: 97%

“…Migraine and coronary heart disease Although some studies yielded negative or conflicting results for the overall association of migraine and coronary heart disease 35 , other studies reported a positive association and even electrocardiographic changes experienced by migraineurs [36][37][38] .…”

Section: Mechanisms Of Association Putative Mechanisms Commentsmentioning

confidence: 99%

Migraine and Cardiovascular Disease

Lipton¹,

Bigal

²

2006

JAMA

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Migraine, especially migraine with aura is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine with and without aura to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication and cardiovascular mortality. The topic is therefore of considerable interest. Accordingly, herein we review the association between migraine and cardiovascular disease. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis. Key words: migraine, cardiovascular disease, stroke. Migrânea e doenças cardiovasculares RESUMOA migrânea, especialmente a migrânea com aura, é fator de risco para lesões cerebrais. Evidência recente sugere que migrânea com e sem aura é associada com outras doenças cardiovasculares isquêmicas, incluindo a angina, o infarto do miocárdio, revascularização coronária, claudicação e morte súbita. Iniciamos discutindo o diagnóstico da migrânea e seus mecanismos fisiopatológicos. Após sumarizar a evidência, discutimos resultados de meta-análise recente. Por fim, ressaltamos resultados de um grande estudo populacional sobre o assunto. Palavras-chave: migrânea, doença cardiovascular, acidente vascular cerebral. The association between migraine and ischemic vascular events has been studied for many years 1,2 . Original studies controversially reported an association between migraine with aura (MA) and stroke. The relationship was stronger in young women, and was magnified by the use of hormonal contraception or by tabagism 1 . Controversial topics included whether migraine without aura (MO) was also a risk factor to stroke, if the association also happened in men, and whether migraine was associated with other forms of cardiovascular disease 3 .The field has advanced considerably in recent years, with the publication of evidence that MA is indeed an established risk factor for subclinical ischemic lesions of the brain 4 , as well as for ischemic stroke, particularly among women of younger age 5,6 . The association has also been shown in men 7 . Furthermore, migraine seems also to be linked with other forms of cardiovascular disease (CVD), including myocardial infarct, angina and claudication), as well as with risk factors to CVD 8,9 . The topic has indeed gained considerable traction and robust evidence is now available. Accordingly, herein we review the association between migraine and CVD. We start by briefly presenting diagnostic criteria for migraine and revising its pathophysiology. We follow by summarizing the evidence on the topic. We then briefly present the results of a recent meta-analysis. We close by highlighting results of a large epidemiological study conducted after the publication of the meta-analysis. Migraine...

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Migraine and other headaches

Abstract: The lack of association of migraines with coronary heart disease suggests that the association of migraine with Rose angina is not related to coronary artery disease. Future research assessing other common underlying pathologic mechanisms is warranted.

Cited by 88 publications

References 47 publications

Migraine and cardiovascular disease

Migraine and cardiovascular disease

Migraine and cardiovascular disease

Migraine and Cardiovascular Disease

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