Should we add Migraine Headaches to the CV Risk Factor List?

A recent prospective study based on data from 115,541 women free of known cardiovascular disease (CVD) who were enrolled in the Nurses’ Health Study II was published in the British Medical Journal.  The researchers sought to determine if there was a link between migraine headaches and incident CVD and CVD mortality in women.  Of the subjects enrolled, 15.2% (n=17,531) had physician diagnosed migraine headaches.  Subjects with diagnosed migraines ranged in age from 25-42 years and were followed for over 20 years with a cumulative follow-up rate >90%.  Despite adjustment for potential confounders, migraine headaches were strongly associated with incident stroke (hazard ratio 1.62, 1.37 – 1.92), coronary revascularization procedures/angina (1.73, 1.20 – 2.32), myocardial infarction (1.39, 1.18 to 1.64) and CVD mortality (1.37, 1.02 – 2.32).  These associations held across various subgroups of women by age (<50/≥50 years) and whether or not they had hypertension or were on oral contraceptives or post-menopausal hormone replacement therapy.

The investigators concluded that there was a strong consistent link between CVD events, including CVD mortality, and migraine headaches and recommended that women with migraine headaches be more aggressively evaluated for vascular risk (and subclinical disease.)

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