Migraine Linked To Increased Risk of Stroke, AFib, PE and Cardiovascular Disease

MedicalResearch.com Interview with:
“Headache.” by Avenue G is licensed under CC BY 2.0
Kasper Adelborg, MD, PhD
Postdoctoral Fellow
Department of Clinical Epidemiology
Aarhus University Hospital 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Around one billion people worldwide are affected by migraine. Migraine has considerable impact on quality of life and imposes a substantial burden on society. Migraine is primarily a headache disorder, but previous studies have suggested a link between migraine and stroke and myocardial infarction, particularly among women, while the link between migraine and other heart problems are less well known.

In this large register-based Danish study published in the BMJ, we confirmed that migraine is associated with increased risks of stroke and myocardial infarction, but we also found that migraine was associated with increased risks of other cardiovascular diseases (specifically, venous thromboembolism and atrial fibrillation). Migraine was not associated with increased risks of heart failure or peripheral artery disease.

In contrast to most previous studies, our study had a very large sample size and an age- and sex- matched comparison cohort from the general population, which allowed us to put migraine in a population context and to perform several subgroup analyses. Here, we found several interesting findings.

  • In general, the associations were strongest in the first year after diagnosis but persisted in the long term (up to 19 years after diagnosis).
  • Most associations applied to both migraine patients with aura (warning signs before a migraine, such as seeing flashing lights) and in those without aura, and in both women and in men. 

MedicalResearch.com: What should readers take away from your report? 

Response: Now accumulating evidence supports that migraine should be considered as a potent and persistent risk factor for most cardiovascular diseases in both men and women.

Although the absolute risks of cardiovascular diseases were low at the individual level, it translates into a substantial increase in risk at the population level, because migraine is a very common disease. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Establishing the link between migraine and cardiovascular risk was an important first step. Now, we need data to inform the development of clinical recommendations and strategies that reduce the risk of cardiovascular disease for patients with migraine.

For example, current migraine guidelines do not recommend use of anticoagulant treatment with aspirin and clopidogrel in the prophylaxis of migraine, but future studies should address whether patients at particularly high risk of cardiovascular diseases would benefit from anticoagulant treatment.

Additionally, it will be important to determine whether prevention strategies in patients with migraine can reduce the burden of cardiovascular disease in patients with this common disorder. 

Disclosures: We report no relevant conflicts of interests.

Citations:

Migraine and risk of cardiovascular diseases: Danish population based matched cohort study

BMJ 2018360 doi: https://doi.org/10.1136/bmj.k96 (Published 31 January 2018)Cite this as: BMJ 2018;360:k96

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