Migraine Linked With Increased Long-Term Cardiovascular, Cerebrovascular Event Risk

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Migraine headache is associated with a higher risk for major adverse cardiovascular and cerebrovascular events.
Migraine headache is associated with a higher risk for major adverse cardiovascular and cerebrovascular events.

Migraine headache is associated with a higher risk for major adverse cardiovascular and cerebrovascular events, including stroke and myocardial infarction, according to a meta-analysis published in BMJ Open.

This systemic review analyzed results from 16 cohort studies, including 394,942 study participants with migraine and 757,465 without migraine. The primary and secondary outcomes were major adverse cardiovascular and cerebrovascular events, stroke,  myocardial infarction (MI), and all-cause mortality.

A greater risk for stroke (adjusted hazard ratio [aHR], 1.41; P <.001) and MI (aHR, 1.23; P =.006) was found for study participants with migraine.  There was no increased risk for all-cause mortality among patients with migraine (aHR 0.93; P =.38).

Aura was an effect modifier for both all-cause mortality (aHR with aura, 1.20; aHR without aura, 0.96; P <.001) and stroke (aHR with aura, 1.56; aHR without aura, 1.11; P =.01). The presence of aura correlates with an increased risk for cardiovascular and cerebrovascular events in the future.

Limitations of this study included different methods for discerning migraine diagnoses, a large amount of statistical heterogeneity between studies, different methods for assessing outcomes, and factors like race and ethnicity that could not properly be accounted for with the given data.

Researchers conclude that migraine is associated with an increased long-term risk of cardiovascular and cerebrovascular events driven primarily by increased risk of stroke and MI.

Reference

Mahmoud AN, Mentias A, Elgendy AY, et al. Migraine and the risk of cardiovascular and cerebrovascular events: a meta-analysis of 16 cohort studies including 1 152 407 subjects [published online March 27, 2018]. BMJ Open. doi: 10.1136/bmjopen-2017-020498

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