CVD risk higher in patients with migraines, study finds

Patients with migraines, especially migraines with aura, could be at greater risk for cardiovascular disease, according to a new study.

Researchers used data from the American Migraine Prevalence and Prevention study to examine the rate of diagnosis of cardiovascular disease (CVD) and CVD risk factors in patients with migraine (n=6,102) and patients without (n=5,243). Migraine diagnosis, treatment, and comorbid conditions, as well as CVD events, were determined via a mailed screening questionnaire. Case-patients with migraine were more likely to be women and of lower income than controls, while controls were younger than case-patients. The results of the study were published online Feb. 10 by Neurology.

The authors found an association in unadjusted analyses between migraine and migraine with aura and myocardial infarction, stroke and claudication; migraine without aura was associated with myocardial infarction and claudication but not stroke. Patients with migraine were more likely than those without to have diagnosed diabetes (12.6% vs. 9.4%; odds ratio [OR], 1.4; 95% CI, 1.2 to 1.6), hypertension (33.1% vs. 27.5%; OR, 1.4; 95% CI, 1.3 to 1.6), and high cholesterol levels (32.7% vs. 25.6%; OR, 1.4; 95% CI, 1.3 to 1.5). Migraine with and without aura was associated with higher Framingham risk scores. In analyses adjusted for sex, age, disability, treatment and CVD risk factors, migraine was associated with myocardial infarction (OR, 2.2; 95% CI, 1.7 to 2.8), stroke (OR, 1.5; 95% CI, 1.2 to 2.1), and claudication (OR, 2.69; 95% CI, 1.98 to 3.23).

The study had several limitations, including reliance on questionnaire data rather than clinical examination. However, the authors concluded that migraine is associated with CVD and its risk factors, although they noted that the increased risk, while statistically significant, may not be clinically relevant. An accompanying editorial also noted the limitations of the study but said that its strengths, including its large representative sample, largely make up for them. "Patients with migraine, in particular those with aura, should be investigated for vascular risk factors and be counseled how to treat them," the editorialists wrote.