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Migraine and risk of cardiovascular disease in women.
JAMA 2006; 296(3):283-91JAMA

Abstract

CONTEXT

Migraine with aura has been associated with an adverse cardiovascular risk profile and prothrombotic factors that, along with migraine-specific physiology, may increase the risk of vascular events. Although migraine with aura has been associated with increased risk of ischemic stroke, an association with cardiovascular disease (CVD) and, specifically, coronary events remains unclear.

OBJECTIVE

To evaluate the association between migraine with and without aura and subsequent risk of overall and specific CVD.

DESIGN, SETTING, AND PARTICIPANTS

Prospective cohort study of 27,840 US women aged 45 years or older who were participating in the Women's Health Study, were free of CVD and angina at study entry (1992-1995), and who had information on self-reported migraine and aura status, and lipid measurements. This report is based on follow-up data through March 31, 2004.

MAIN OUTCOME MEASURES

The primary outcome measure was the combined end point of major CVD (first instance of nonfatal ischemic stroke, nonfatal myocardial infarction, or death due to ischemic CVD); other measures were first ischemic stroke, myocardial infarction, coronary revascularization, angina, and death due to ischemic CVD.

RESULTS

At baseline, 5125 women (18.4%) reported any history of migraine; of the 3610 with active migraine (migraine in the prior year), 1434 (39.7%) indicated aura symptoms. During a mean of 10 years of follow-up, 580 major CVD events occurred. Compared with women with no migraine history, women who reported active migraine with aura had multivariable-adjusted hazard ratios of 2.15 (95% confidence interval [CI], 1.58-2.92; P<.001) for major CVD, 1.91 (95% CI, 1.17-3.10; P = .01) for ischemic stroke, 2.08 (95% CI, 1.30-3.31; P = .002) for myocardial infarction, 1.74 (95% CI, 1.23-2.46; P = .002) for coronary revascularization, 1.71 (95% CI, 1.16-2.53; P = .007) for angina, and 2.33 (95% CI, 1.21-4.51; P = .01) for ischemic CVD death. After adjusting for age, there were 18 additional major CVD events attributable to migraine with aura per 10 000 women per year. Women who reported active migraine without aura did not have increased risk of any vascular events or angina.

CONCLUSIONS

In this large, prospective cohort of women, active migraine with aura was associated with increased risk of major CVD, myocardial infarction, ischemic stroke, and death due to ischemic CVD, as well as with coronary revascularization and angina. Active migraine without aura was not associated with increased risk of any CVD event.

Authors+Show Affiliations

Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02215-1204, USA. tkurth@rics.bwh.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16849661

Citation

Kurth, Tobias, et al. "Migraine and Risk of Cardiovascular Disease in Women." JAMA, vol. 296, no. 3, 2006, pp. 283-91.
Kurth T, Gaziano JM, Cook NR, et al. Migraine and risk of cardiovascular disease in women. JAMA. 2006;296(3):283-91.
Kurth, T., Gaziano, J. M., Cook, N. R., Logroscino, G., Diener, H. C., & Buring, J. E. (2006). Migraine and risk of cardiovascular disease in women. JAMA, 296(3), pp. 283-91.
Kurth T, et al. Migraine and Risk of Cardiovascular Disease in Women. JAMA. 2006 Jul 19;296(3):283-91. PubMed PMID: 16849661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Migraine and risk of cardiovascular disease in women. AU - Kurth,Tobias, AU - Gaziano,J Michael, AU - Cook,Nancy R, AU - Logroscino,Giancarlo, AU - Diener,Hans-Christoph, AU - Buring,Julie E, PY - 2006/7/20/pubmed PY - 2006/7/25/medline PY - 2006/7/20/entrez SP - 283 EP - 91 JF - JAMA JO - JAMA VL - 296 IS - 3 N2 - CONTEXT: Migraine with aura has been associated with an adverse cardiovascular risk profile and prothrombotic factors that, along with migraine-specific physiology, may increase the risk of vascular events. Although migraine with aura has been associated with increased risk of ischemic stroke, an association with cardiovascular disease (CVD) and, specifically, coronary events remains unclear. OBJECTIVE: To evaluate the association between migraine with and without aura and subsequent risk of overall and specific CVD. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of 27,840 US women aged 45 years or older who were participating in the Women's Health Study, were free of CVD and angina at study entry (1992-1995), and who had information on self-reported migraine and aura status, and lipid measurements. This report is based on follow-up data through March 31, 2004. MAIN OUTCOME MEASURES: The primary outcome measure was the combined end point of major CVD (first instance of nonfatal ischemic stroke, nonfatal myocardial infarction, or death due to ischemic CVD); other measures were first ischemic stroke, myocardial infarction, coronary revascularization, angina, and death due to ischemic CVD. RESULTS: At baseline, 5125 women (18.4%) reported any history of migraine; of the 3610 with active migraine (migraine in the prior year), 1434 (39.7%) indicated aura symptoms. During a mean of 10 years of follow-up, 580 major CVD events occurred. Compared with women with no migraine history, women who reported active migraine with aura had multivariable-adjusted hazard ratios of 2.15 (95% confidence interval [CI], 1.58-2.92; P<.001) for major CVD, 1.91 (95% CI, 1.17-3.10; P = .01) for ischemic stroke, 2.08 (95% CI, 1.30-3.31; P = .002) for myocardial infarction, 1.74 (95% CI, 1.23-2.46; P = .002) for coronary revascularization, 1.71 (95% CI, 1.16-2.53; P = .007) for angina, and 2.33 (95% CI, 1.21-4.51; P = .01) for ischemic CVD death. After adjusting for age, there were 18 additional major CVD events attributable to migraine with aura per 10 000 women per year. Women who reported active migraine without aura did not have increased risk of any vascular events or angina. CONCLUSIONS: In this large, prospective cohort of women, active migraine with aura was associated with increased risk of major CVD, myocardial infarction, ischemic stroke, and death due to ischemic CVD, as well as with coronary revascularization and angina. Active migraine without aura was not associated with increased risk of any CVD event. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/16849661/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.296.3.283 DB - PRIME DP - Unbound Medicine ER -