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Migraine and cardiovascular disease: a population-based study.
Neurology 2010; 74(8):628-35Neur

Abstract

OBJECTIVES

Although the relationship between migraine and cardiovascular disease (CVD) has been studied, several questions remain unanswered. Herein we contrast the rate of diagnosed CVD as well as of risk factors for CVD in individuals with migraine with and without aura (MA and MO) and in controls.

METHODS

In this case-control study, migraineurs (n = 6,102) and controls (n = 5,243) were representative of the adult US population. Headache diagnosis was formally assigned using a validated mailed questionnaire which also obtained details on treatment, comorbidities, and other variables. CVD events were obtained based on self-reported medical diagnosis. Risk factors for CVD and modified Framingham scores were computed.

RESULTS

In unadjusted analyses, migraine overall and MA were associated with myocardial infarction, stroke, and claudication, and MO was associated with myocardial infarction and claudication. Migraineurs were more likely than controls to have a medical diagnosis of diabetes (12.6% vs 9.4%, odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2-1.6), hypertension (33.1% vs 27.5%, OR 1.4, 95% CI 1.3-1.6), and high cholesterol (32.7% vs 25.6%, OR 1.4, 95% CI 1.3-1.5). Risk was highest in MA, but remained elevated in MO. Framingham scores were significantly higher in MO and MA than in controls. After adjustments (gender, age, disability, treatment, CVD risk factors), migraine remained significantly associated with myocardial infarction (OR 2.2, 95% CI 1.7-2.8), stroke (OR 1.5, 95% CI 1.2-2.1), and claudication (OR 2.69, 95% CI 1.98-3.23).

CONCLUSION

Both migraine with and without aura are associated with cardiovascular disease (CVD) and with risk factors for CVD. However, since our sample size is large, the clinical relevance of the differences is yet to be established.

Authors+Show Affiliations

1 Merck Dr., PO Box 100, Whitehouse Station, NJ 08889-0100, USA. marcelo_bigal@merck.comNo affiliation info availableNo 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

20147658

Citation

Bigal, M E., et al. "Migraine and Cardiovascular Disease: a Population-based Study." Neurology, vol. 74, no. 8, 2010, pp. 628-35.
Bigal ME, Kurth T, Santanello N, et al. Migraine and cardiovascular disease: a population-based study. Neurology. 2010;74(8):628-35.
Bigal, M. E., Kurth, T., Santanello, N., Buse, D., Golden, W., Robbins, M., & Lipton, R. B. (2010). Migraine and cardiovascular disease: a population-based study. Neurology, 74(8), pp. 628-35. doi:10.1212/WNL.0b013e3181d0cc8b.
Bigal ME, et al. Migraine and Cardiovascular Disease: a Population-based Study. Neurology. 2010 Feb 23;74(8):628-35. PubMed PMID: 20147658.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Migraine and cardiovascular disease: a population-based study. AU - Bigal,M E, AU - Kurth,T, AU - Santanello,N, AU - Buse,D, AU - Golden,W, AU - Robbins,M, AU - Lipton,R B, Y1 - 2010/02/10/ PY - 2010/2/12/entrez PY - 2010/2/12/pubmed PY - 2010/3/27/medline SP - 628 EP - 35 JF - Neurology JO - Neurology VL - 74 IS - 8 N2 - OBJECTIVES: Although the relationship between migraine and cardiovascular disease (CVD) has been studied, several questions remain unanswered. Herein we contrast the rate of diagnosed CVD as well as of risk factors for CVD in individuals with migraine with and without aura (MA and MO) and in controls. METHODS: In this case-control study, migraineurs (n = 6,102) and controls (n = 5,243) were representative of the adult US population. Headache diagnosis was formally assigned using a validated mailed questionnaire which also obtained details on treatment, comorbidities, and other variables. CVD events were obtained based on self-reported medical diagnosis. Risk factors for CVD and modified Framingham scores were computed. RESULTS: In unadjusted analyses, migraine overall and MA were associated with myocardial infarction, stroke, and claudication, and MO was associated with myocardial infarction and claudication. Migraineurs were more likely than controls to have a medical diagnosis of diabetes (12.6% vs 9.4%, odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2-1.6), hypertension (33.1% vs 27.5%, OR 1.4, 95% CI 1.3-1.6), and high cholesterol (32.7% vs 25.6%, OR 1.4, 95% CI 1.3-1.5). Risk was highest in MA, but remained elevated in MO. Framingham scores were significantly higher in MO and MA than in controls. After adjustments (gender, age, disability, treatment, CVD risk factors), migraine remained significantly associated with myocardial infarction (OR 2.2, 95% CI 1.7-2.8), stroke (OR 1.5, 95% CI 1.2-2.1), and claudication (OR 2.69, 95% CI 1.98-3.23). CONCLUSION: Both migraine with and without aura are associated with cardiovascular disease (CVD) and with risk factors for CVD. However, since our sample size is large, the clinical relevance of the differences is yet to be established. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/20147658/Migraine_and_cardiovascular_disease:_a_population_based_study_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=20147658 DB - PRIME DP - Unbound Medicine ER -