Migraine Increases Risk of Stroke and MI in Women and Men

BY MAURY M. BREECHER
Contributing Writer

ORLANDO - (ECCC) Migraine appears to be a risk factor for cardiovascular disease in both men and women, said Dr. Glen D. Solomon on July 20 at a symposium sponsored by the Diamond Headache Clinic Research and Education Foundation.

Dr. Solomon, chairman of the department of medicine at Advocate Lutheran General Hospital in Park Ridge, IL, pointed out that a 10-year follow-up of the long- running Women's Health Study of 40,000 female healthcare professionals over age 45 has revealed an 18.4% prevalence of migraine. Of those women, 40% reported migraine with aura in the past year.

Dr. Solomon said this is a concern because, “Women who reported migraine with aura had increased risk of ischemic stroke, myocardial infarction, and angina compared to either women with no migraine or to women with migraine without aura.”

Women with migraine and aura had a three-fold greater elevated stroke risk than women without migraine. That risk shows up before the women reach age 35.

Migraine also appears to increase the risk of cardiovascular disease for men, said Dr. Solomon, citing an almost 16-year follow-up (15.7 years) of data from The Physician's Health Study of 20,084 male physicians. Prevalence of migraine in that population group was about 7%, “about what might be expected in the general population,” said Dr. Solomon.

However, after 15 years the men with migraine were shown to have a 24% increased risk for cardiovascular events and a 42% increased risk of myocardial infarction. Unlike the Women's Health Study, the Physician's Health Study did not differentiate migraine with aura versus migraine without aura.

Dr. Solomon also said that the National Health and Nutrition Evaluation Survey reported the risk of stroke to be doubled in both male and female migraineurs (CNS Drugs 2005;19:683-92).

“I think that what we can conclude from these studies is that migraine, and probably more specifically migraine with aura, is a risk factor for cardiovascular disease, particularly MI and stroke,” he said.

And why do people with migraine have higher risk factors for cardiovascular disease?

“We find that migraineurs are more likely to smoke, to not drink alcohol because alcohol is commonly a trigger for migraines, but is thought to be protective against coronary disease, and they have a parental history of early MI,” explained Dr. Solomon.

“When we look at people with migraine and aura, we find they are likely to have higher cholesterol, a bad HDL-to-LDL ratio, and are more likely to have high BP and early onset of heart disease or stroke,” he continued.

Indeed, the literature confirms this. Female migraineurs with aura are more likely to have elevated cholesterol (>240), total cholesterol:HDL ratios >5.0, elevated blood pressure, and have early onset stroke (Neurology 2005;64:614-20).

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