Migraine in women associated with increased risk cardiovascular disease

by Bruce Sylvester: Women who suffer migraines appear to have an increased risk of heart attacks and strokes as well as a higher rate of mortality from cardiovascular disease, researchers reported on May 31, 2016 in The BMJ today.

“These results further add to the evidence that migraine should be considered an important risk marker for cardiovascular disease, at least in women,” the authors said.

The researchers analyzed data from 115,541 women enrolled in the Nurses’ Health Study II. At baseline, the subjects ranged in age from 25 to 42 years, and they were free from angina and cardiovascular disease. They were tracked from 1989-2011 for cardiovascular events, diseases and mortality.

Overall, 17,531 (15.2%) women had migraine at baseline. Over 20 years of follow-up, 1,329 total cardiovascular disease events appeared in this subpopulation, and 223 women died from cardiovascular disease.

The researchers reported that, after adjusting for the other common risk factors, the women with migraine at baseline had a significantly elevated risk for developing major cardiovascular disease than women without migraine (hazard ratio 1.50, confidence interval 1.33 to 1.69). The greatest increase in risk was for stroke (HR 1.62) and for angina/coronary revascularizations (HR 1.73).

Also, migraine was associated with an increased risk of cardiovascular mortality, and the association held across subgroups of women designated by age, smoking status, hypertension, postmenopausal hormone therapy, and oral contraceptive use.

In a linked editorial, Rebecca Burch, MD, instructor at Harvard Medical School in Boston and Melissa Rayhill, MD, clinical assistant professor at The State University of New York at Buffalo said that “the magnitude of the risk should not be over-emphasized,” as “it is small at the level of the individual patient, but still important at a population level because migraine is so prevalent.”

The editorialists added, “it’s time to add migraine to the list of early life medical conditions that are markers for later life cardiovascular risk.”