Migraine With Aura Increases Risk for Carotid Thickening in Middle-Aged Women

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This is the first study to evaluate the prevalence of the markers of vascular damage in migraineurs.
This is the first study to evaluate the prevalence of the markers of vascular damage in migraineurs.

Migraine with aura is associated with an increased risk for diffuse carotid thickening and migraine without aura is associated with a low risk for carotid plaques and arterial stiffening in middle-aged women, according to a study published in Headache.

This cross-sectional study was derived from a previous study, from which 277 participants (45-65 years old) were recruited and included in the final sample. Laboratory test data included total cholesterol, high-density lipoproteins cholesterol, triglycerides levels, apnea-hypopnea index, and general cardiovascular risk profile. Carotid artery assessment was performed by a radiologist using high-resolution B-mode carotid artery ultrasonography. Mean carotid intima-media thickness (CIMT) >0.9 mm was classified as increased CIMT or carotid thickening. Carotid-femoral pulse wave velocity assessment was performed by a cardiologist blinded to the study parameters.

Migraine was diagnosed by a headache expert neurologist, using the third edition-beta of the International Classification of Headache Disorders criteria. Participants were divided into migraine (including probable migraine) and nonmigraine groups; the migraine group was subdivided into the migraine with aura and migraine without aura groups.

In analyses adjusted for covariates, carotid thickening was found to be statistically significant in participants with migraine with aura (odds ratio 7.12 [95% CI, 1.05–48.49]; =.045), compared with participants without migraine. The risks of carotid plaques and arterial stiffening were lower in the migraine without aura group than in participants without migraine.

The inclusion of only middle-aged women limited the generalizability of the results. In addition, the exclusion of participants with prior cardiovascular disease prevented examining the possibility that markers of vascular damage are underestimated in patients with migraine.

Based on their findings, the researchers suggest that "evaluating CIMT appears to be a useful marker of vascular damage in migraineurs, and carotid thickening is possibly related to a migraine-specific mechanism of vascular dysfunction.”

Reference

Magalhães JE, de Barros IML, Pedrosa RP, Sampaio Rocha-Filho PA. Migraine and markers of carotid atherosclerosis in middle-aged women: a cross-sectional study [published online December 5, 2018]. Headache. doi: 10.1111/head.13460

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