Migraines May Increase CVD Risk in Women

Women with migraines face a 50% greater risk of developing major cardiovascular disease (CVD), recent study results suggest.

Migraine is a common headache disorder with a lifetime prevalence of 25% among US women, which is 3 to 4 times greater than the prevalence among men.

Although the pathophysiology of migraine is closely linked to the vascular system, the exact mechanism linking migraine to CVD events remains unknown. For that reason, a recent study sought to investigate the relationship between migraine and incident CVD among women.

The 20-year prospective cohort study of more than 115,000 female US nurses included in the Nurses’ Healthy Study II and aged 25 to 42 years at inclusion in 1989 found consistent links among migraine, cardiovascular events, and CVD mortality. Researchers derived health data from self-administered questionnaires updated every 2 years and medical records, while causes of death were verified by autopsy reports, medical reports, and death certificates.

Study participants were free of angina and CVD at baseline, and the investigators controlled for certain risk factors, including age, cholesterol level, diabetes, hypertension, body mass index, smoking status, menopausal status, and family history of myocardial infarction prior to age 60, as well as use of aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs.

Of those included in the study, 15.2% (17,531) reported a physician’s diagnosis of migraine at baseline, while an additional 18% (6389) reported a migraine diagnosis during follow-up.

Women with migraines were found to have a 50% greater risk for heart attack, stroke, or surgery to open blocked heart arteries than their non-migraine-afflicted counterparts. Migraine incidence was also associated with a 37% increased chance of mortality from heart attack or stroke.

These observed trends prevailed even after the researchers controlled for other risk factors, including smoking, high blood pressure, age, and use of oral contraceptives.

“Migraine should be considered a marker for increased risk of [CVD], at least in women,” concluded lead researcher Tobias Kurth, director of the Institute of Public Health at Charite-Universitatsmedizin in Berlin, Germany, in a press release.

Notably, migraine tends to present earlier in life, while CVD tends to present later.

Retail clinicians treating patients of all ages with migraine should consider assessing the patient’s total CVD risk profile and addressing modifiable risk factors, which include tobacco use, hypertension, high cholesterol, obesity, physical inactivity, diabetes, unhealthy diet, and harmful use of alcohol.

The latest research, which was published inBMJ,represents one of the largest prospective cohort studies to-date on the health of younger women. Its findings were consistent with previous research linking migraine incidence to heightened CVD risk.