Does Migraine in Women Lead to Higher CV Risk?

Women who suffer from migraine may be at an increased risk for cardiovascular disease and death from cardiovascular disease, according to the results of a study published recently in BMJ.

A large prospective study of data from the Nurses’ Health Study (NHS) II showed that migraine was associated with increased risk for cardiovascular disease, myocardial infarction, and stroke.

“Results of this large, prospective cohort study among women support the hypothesis that migraine is a marker for increased risk of any cardiovascular events,” wrote researcher Tobias Kurth, of the Institute of Public Health, Berlin, Germany, and colleagues. “Given the high prevalence of migraine in the general population, an urgent need exists to understand the biological processes involved and to provide preventive solutions for patients.”

Migraine occurs in about one in five people in the United States, according to the study. Previous studies have found an association between migraine with aura and increased risk for stroke; however, finding links between migraine and other cardiovascular disease events has been difficult.

For this study, Kurth and colleagues used data taken from the cohort NHS II study with follow-up available from 1989 to June 2011. The study included 115,541 women aged 25 to 42 at baseline who did not have angina or cardiovascular disease. They studied if migraine was associated with a combined endpoint of myocardial infarction, stroke, or fatal cardiovascular disease.

Of the cohort, 15.2% of women reported a physician’s diagnosis of migraine at baseline and an additional 6,389 women reported subsequent migraine diagnosis. During the 20-year follow-up, 1,329 major cardiovascular disease events occurred with 223 deaths due to cardiovascular disease.

Adjusting for potential confounders, the researchers found that women with migraine had a 50% increased risk for major cardiovascular disease (hazard ratio [HR]=1.50; 95% CI, 1.33-1.69) compared with women without migraine. In addition, migraine was linked with an increased risk of myocardial infarction (HR=1.39; 95% CI, 1.18-1.64), stroke (HR=1.62; 95% CI, 1.37-1.92), and angina/coronary revascularization procedures (HR=1.73; 95% CI, 1.29-2.32).

Finally, the researchers found that women with migraine had a 37% increased risk for death from cardiovascular disease (HR=1.37; 95% CI, 1.02-1.83) compared with those women without migraine.

 “Several mechanisms that have been implied for migraine have also been linked with increased risk of cardiovascular disease, such as increased thrombogenic susceptibility, shared genetic markers, and inflammation processes,” the researchers wrote. “Our findings confirm results of other studies that women with migraine have a higher prevalence of vascular risk factors, such as hypertension, higher body mass index, and hypercholesterolemia. However, as all studies evaluating the association between migraine and cardiovascular disease have controlled for these factors, the association between migraine and cardiovascular disease is unlikely to be explained by this.”

Reference: Kurth T, et al. Migraine and risk of cardiovascular disease in women: prospective cohort study. BMJ. 2016;253:i2610.