Migraine Headache and Long-Term Cardiovascular Outcomes: An Extended Follow-Up of the Women's Ischemia Syndrome Evaluation

Rambarat, Cecil A.; Elgendy, Islam Y.; Johnson, B. Delia; Reis, Steven E.; Thompson, Diane V; Sharaf, Barry L.; Bittner, Vera; Sopko, George; Merz, C. Noel Bairey; Pepine, Carl J.; Ahmed, Bina

doi:10.1016/j.amjmed.2016.12.028

Cited by 34 publications

(39 citation statements)

References 18 publications

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“…No overall association was found in a 2011 meta-analysis of five pooled studies [10]. More recently, no association with all-cause mortality was observed in two large cohort studies [11,12]. A recent Taiwanese study found that people with migraine had lower all-cause mortality than individuals without migraine, though this study did only captured in-hospital mortality and many important sources of confounding may have been omitted by the variable selection process [13].…”

Section: Introductionmentioning

confidence: 87%

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Migraine, headache, and mortality in women: a cohort study

et al. 2020

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Background: Migraine carries a high global burden, disproportionately affects women, and has been implicated as a risk factor for cardiovascular disease. Migraine with aura has been consistently associated with increased risk of cardiovascular mortality. However, published evidence on relationships between migraine or non-migraine headache and all-cause mortality is inconclusive. Therefore, we aimed to estimate the effect of non-migraine headache and migraine as well as migraine subtypes on all-cause and cause-specific mortality in women. Methods: In total, 27,844 Women's Health Study participants, aged 45 years or older at baseline, were followed up for a median of 22.7 years. We included participants who provided information on migraine (past history, migraine without aura, or migraine with aura) or headache status and a blood sample at study start. An endpoints committee of physicians evaluated reports of incident deaths and used medical records to confirm deaths due to cardiovascular, cancer, or female-specific cancer causes. We used multivariable Cox proportional hazards models to estimate the effect of migraine or headache status on both all-cause and cause-specific mortality. Results: Compared to individuals without any headache, no differences in all-cause mortality for individuals suffering from non-migraine headache or any migraine were observed after adjustment for confounding (HR = 1.01, 95%CI, 0.93-1.10 and HR = 0.96, 95% CI: 0.89-1.04). No differences were observed for the migraine subtypes and all-cause death. Women having the migraine with aura subtype had a higher mortality due to cardiovascular disease (adjusted HR = 1.64, 95%CI: 1.06-2.54). As an explanation for the lack of overall association with all-cause mortality, we observed slightly protective signals for any cancer and female-specific cancers in this group. Conclusions: In this large prospective study of women, we found no association between non-migraine headache or migraine and all-cause mortality. Women suffering from migraine with aura had an increased risk of cardiovascular death. Future studies should investigate the reasons for the increased risk of cardiovascular mortality and evaluate whether changes in migraine patterns across the life course have differential effects on mortality.

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Section: Introductionmentioning

confidence: 87%

“…Migraine and non-migraine headache have not been consistently linked with an increased risk of all-cause mortality [10][11][12]. Some studies even suggested a decreased risk [20].…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Migraine, headache, and mortality in women: a cohort study

et al. 2020

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“…Globally, migraines are approximately twice as prevalent in females as in males, particularly affecting young and middle-aged females with menstrual cycles [ 3 , 4 , 5 ]. Migraines affect the central nervous system and impair daily life for those affected, cause comorbid psychological conditions, and increase the risk of cardiovascular diseases for patients [ 6 , 7 ]. Investigations continue regarding the detailed mechanism and risk factors for migraines.…”

Section: Introductionmentioning

confidence: 99%

Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study

Harnod

Lin

Kao

2018

JCM

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Objective: To investigate the risk and risk factors for suicide attempt by patients with regular migraines (RM) and status migrainosus (SM) in Taiwan. Methods: We analyzed a subset of the National Health Insurance Research Database of Taiwan and enrolled patients (≥20 years old) who had ever received a diagnosis of RM or SM between 2000 and 2012 in the RM and SM cohort. The SM cohort included 13,605 patients, the RM cohort had 21,485 patients, and the comparison cohort contained approximately four times that many patients. We calculated the adjusted hazard ratios and 95% confidence intervals (CI) for suicide attempts after adjusting for age, sex, monthly income, urbanization level, occupation, and comorbidities. Results: The SM cohort had a 1.81-fold risk of attempting suicide (95% CI = 1.14–2.89) compared to the comparison cohort. Other factors that predispose patients with SM to attempt suicide include the following: female sex, relatively young age (<50 years old), and low monthly income (<15,000 New Taiwan Dollars, approximately equivalent to 495 US Dollars). Additionally, the risk of attempting suicide only increased in patients who had been diagnosed with SM for longer than five years. Conclusion: SM is associated with a higher risk for suicide attempt in migraineurs in Taiwan. This finding is important to clinicians and government officials seeking to prevent patients from attempting suicide in Taiwan and other similar East Asian countries.

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“…Patients with the diagnosis of migraine have a 1.5 times greater risk of developing acute myocardial infarction, angina, and stroke,22 which increases mortality by cardiovascular diseases by 1.37 times 23. The main risk is related to cerebral ischemia 24 , 25…”

Section: Discussionmentioning

confidence: 99%

Migrainous infarction: a rare and often overlooked diagnosis

Kreling¹,

Neto²,

Neto³

2017

Autops. Case Rep.

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Migraine is a neurological entity and a well-known independent risk factor for cerebral infarction, which mostly afflicts the young female population. Researching focal neurological signs in this subset of the population with the diagnosis of a neurological ischemic event should always take into account the migraine as the etiology or as an associated factor. The etiology of central nervous system (CNS) ischemia is considerable. Migraine, although rare, also may be included in this vast etiological range, which is called migrainous infarction. In this setting, the diagnostic criteria required for this diagnosis is extensive. Herein, we present the case of a female adolescent who submitted to the emergency facility complaining of diplopia, dysarthria, and imbalance, which started concomitantly with a migrainous crisis with aura—a challenging clinical case that required extensive research to address all possible differential diagnoses.

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Migraine Headache and Long-Term Cardiovascular Outcomes: An Extended Follow-Up of the Women's Ischemia Syndrome Evaluation

Abstract: Among women being evaluated for ischemic heart disease, those reporting a history of migraine headache had increased risk of future cardiovascular events on long-term follow-up. This risk was primarily driven by a more-than twofold increase in the risk of stroke.

Cited by 34 publications

References 18 publications

Migraine, headache, and mortality in women: a cohort study

Migraine, headache, and mortality in women: a cohort study

Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study

Migrainous infarction: a rare and often overlooked diagnosis

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