Migraine with aura associated with increased risk of CVD in women
Clinical QuestionAre women with migraine headaches at an increased risk of cardiovascular disease?
Bottom LineWomen suffering from active migraines with aura are at an increased risk of ischemic vascular events, including coronary heart disease and stroke. In general, this correlates to 18 additional cardiovascular events for every 10,000 women per year. Women with active migraine without aura are not at an increased risk of ischemic vascular disease. (LOE = 2b-)
ReferenceKurth T, Gaziano JM, Cook NR, Logroscino G, Diener HC, Buring JE. Migraine and risk of cardiovascular disease in women. JAMA 2006;296:283-291. [PMID:16849661]
Study DesignCohort (prospective)
SynopsisThese investigators identified 27,840 US women aged 45 years or older who participated in the Women's Health Study. Eligibility criteria included the availablility of information on lipid measurements and self-reported migraine and aura status, and no history of cardiovascular disease (CVD), cancer, or other major illness at baseline. Follow-up occurred for more than 97% of the subjects for a mean of 10 years. Participants self-reported cardiovascular events, and medical records were reviewed by an end points committee to verify outcomes. The authors do not specifically state whether the individuals assessing outcomes remained blinded to study subjects' migraine status. Data analysis included a multivariable model controlling for age, blood pressure, antihypertensive medication use, diabetes, body mass index, smoking, alcohol consumption, exercise, menopausal status, hormone replacement therapy, oral contraceptive use, family history of CVD, and plasma lipid levels. A total of 5125 participants reported a history of migraines, with 1434 reporting active migraine with aura. Compared with women with no migraine history, the incidence rates of all outcome events -- including coronary revascularizations, ischemic strokes, myocardial infarctions, and ischemic CVD deaths -- were significantly higher among women reporting active migraine with aura. After adjusting for age, there were 18 additional major cardiovascular events for every 10,000 women per year reporting active migraine with aura. Active migraine without aura was not associated with a significant increased risk of any cardiovascular outcome event.
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