Migraine Frequency, Aura Tied to CV Disease Risk
Wendling, Patrice, Clinical Psychiatry News
CHICAGO -- Migraine frequency appears to be an indicator of increased risk of cardiovascular disease in migraineurs with aura, according to findings from a large cohort analysis presented at the annual meeting of the American Academy of Neurology.
The study, which used data from the Women's Health Study involving 27,798 women with no history of cardiovascular disease (CVD), identified a mixed association between migraine frequency and major cerebrovascular disease.
Compared with women without migraine, women who had at least weekly migraines were almost three times more likely to suffer a stroke, whereas those with migraines less than once a month were one-and-a-half times more likely to have a heart attack, Dr. Tobias Kurth and associates reported.
However, the increased risk of disease according to migraine frequency was apparent only for migraineurs with aura.
"The clinical implications of our data at this point are unclear," Dr. Kurth said. "The strongest evidence from our study and others is that migraine without aura is not associated with increased risk of cardiovascular disease.
"Future studies should focus on identifying patients with migraine and aura who are at particular increased risk of CVD."
At the start of the study, 3,568 women (mean age 55 years) had migraine based on self-reported questionnaires, of which 1,468 (41%) women reported had aura.
Overall, 2,315 women reported migraine less than once a month, 1,073 reported one migraine per month, and 180 reported at least weekly migraines.
After an average of 12 years follow-up, there were 706 cerebrovascular events, 305 heart attacks, and 310 ischemic strokes.
In a multivariate analysis that adjusted for age, hypertension, smoking status, body mass index, total cholesterol, and history of myocardial infarction, the risk for major cardiovascular disease was increased among those with at least weekly migraines (hazard ratio 1.90), as compared with women with migraine less than once a month (HR 1.54) and those with one migraine per month (HR 0.97).
A different emphasis emerged for risk of ischemic stroke and MI, said Dr. …