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Migraine and cardiovascular disease: possible mechanisms of interaction.
Neurology 2009; 72(21):1864-71Neur

Abstract

Migraine, especially migraine with aura (MA), is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication, and cardiovascular mortality. The mechanisms which link migraine to ischemic vascular disease remain uncertain and are likely to be complex. Cortical spreading depression, the presumed substrate of aura, may directly predispose to brain lesions and that would explain why MA is consistently demonstrated as a risk factor for cerebral ischemia, while for migraine without aura (MO), the evidence is less consistent. Additionally, individuals with migraine have a higher prevalence of risk factors known to be associated with cardiovascular disease (CVD), including hypertension, diabetes, and hyperlipidemia. The increased prevalence of CVD risk factors is also higher for MA than for MO. Since the evidence linking migraine and CVD is getting robust, neurologists should be aware of this association. Individuals with MO seem to be at little increased risk of CVD. MA is associated with an increased risk of ischemic stroke and likely also for other ischemic CVD events. Accordingly, heightened vigilance is recommended for modifiable cardiovascular risk factors in migraineurs, especially with MA. Ultimately, it will be important to determine whether MA is a modifiable risk factor for CVD and if preventive medications for migraine or antiplatelet therapy might reduce the risk of CVD in patients with MA.

Authors+Show Affiliations

Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA. marcelo_bigal@merck.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19470970

Citation

Bigal, M E., et al. "Migraine and Cardiovascular Disease: Possible Mechanisms of Interaction." Neurology, vol. 72, no. 21, 2009, pp. 1864-71.
Bigal ME, Kurth T, Hu H, et al. Migraine and cardiovascular disease: possible mechanisms of interaction. Neurology. 2009;72(21):1864-71.
Bigal, M. E., Kurth, T., Hu, H., Santanello, N., & Lipton, R. B. (2009). Migraine and cardiovascular disease: possible mechanisms of interaction. Neurology, 72(21), pp. 1864-71. doi:10.1212/WNL.0b013e3181a71220.
Bigal ME, et al. Migraine and Cardiovascular Disease: Possible Mechanisms of Interaction. Neurology. 2009 May 26;72(21):1864-71. PubMed PMID: 19470970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Migraine and cardiovascular disease: possible mechanisms of interaction. AU - Bigal,M E, AU - Kurth,T, AU - Hu,H, AU - Santanello,N, AU - Lipton,R B, PY - 2009/5/28/entrez PY - 2009/5/28/pubmed PY - 2009/6/26/medline SP - 1864 EP - 71 JF - Neurology JO - Neurology VL - 72 IS - 21 N2 - Migraine, especially migraine with aura (MA), is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication, and cardiovascular mortality. The mechanisms which link migraine to ischemic vascular disease remain uncertain and are likely to be complex. Cortical spreading depression, the presumed substrate of aura, may directly predispose to brain lesions and that would explain why MA is consistently demonstrated as a risk factor for cerebral ischemia, while for migraine without aura (MO), the evidence is less consistent. Additionally, individuals with migraine have a higher prevalence of risk factors known to be associated with cardiovascular disease (CVD), including hypertension, diabetes, and hyperlipidemia. The increased prevalence of CVD risk factors is also higher for MA than for MO. Since the evidence linking migraine and CVD is getting robust, neurologists should be aware of this association. Individuals with MO seem to be at little increased risk of CVD. MA is associated with an increased risk of ischemic stroke and likely also for other ischemic CVD events. Accordingly, heightened vigilance is recommended for modifiable cardiovascular risk factors in migraineurs, especially with MA. Ultimately, it will be important to determine whether MA is a modifiable risk factor for CVD and if preventive medications for migraine or antiplatelet therapy might reduce the risk of CVD in patients with MA. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/19470970/Migraine_and_cardiovascular_disease:_possible_mechanisms_of_interaction_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=19470970 DB - PRIME DP - Unbound Medicine ER -