A prospective cohort study has shown that middle aged women who suffer from migraines are at an increased risk for adverse cardiovascular events. There is an urgency to understand the biological processes behind this in order to implement preventative measures.
Migraines, a headache disorder, affect one fifth of general the population. Women are often affected two to three times more than men. Migraines (specifically migraines with aura) have been associated with a greater risk of stroke and an increased risk of adverse cardiovascular events. However, the link between migraines and cardiovascular disease is not easily identifiable and there have been few prospective studies that have reported an association between migraines and any cardiovascular disease or adverse events. The current research aims to evaluate the association of migraines with cardiovascular disease events as well as cardiovascular disease specific mortality in younger women, aged 25 to 42. This specific age group was chosen because migraine incidence peaks in midlife.
The Nurses Health Study II, an ongoing prospective study, was the source for participant recruitment. 115,541 women free of angina or any symptomatic cardiovascular disease were used as participants for this research. On the baseline and two follow-up questionnaires, women were asked to indicate whether a physician had diagnosed them as having migraines. Every two years, women then reported any incidents of cardiovascular disease events on follow-up questionnaires, and then completed a supplemental questionnaire confirming the event.
Results indicated that women with migraines were more likely to have an unfavourable cardiovascular risk factor profile. This included hypertension, hypercholesterolemia, a family history of heart attack, a body mass index of 30 or above, and a current smoking status. These women were also more likely to use aspirin, acetaminophen, and anti-inflammatory drugs for a variety of symptoms. Findings were significant for all evaluated individual cardiovascular events, and the highest rates were seen for stroke and angina.
In this prospective cohort study of female nurses aged 25 to 42 who were free of cardiovascular disease at the start of follow-up, results found consistent associations between migraine and cardiovascular disease events. There was found to be an approximately 50% increased risk for major cardiovascular disease. An increased risk of cardiovascular disease mortality was also discovered. There were many strengths of this study including the large number of participants, increasing statistical power, and the long follow-up time.
Results support the hypothesis that migraines are a marker for increased risk of any cardiovascular events. Given the high prevalence of migraines in the general population, there is an urgent need to understand the biological processes involved and to provide preventive solutions for patients.
Written By: Rachel Berkovich, BSc