For several years now, studies have shown an association between migraine and cardiovascular disease and incidents. Cardiovascular disease (CVD) and events include diseases and events related to the heart and blood vessels and include:
- heart attack, aka myocardial infarction;
- atherosclerosis: a condition in which plaque builds up in the walls of the arteries;
- heart failure;
- arrhythmias, which are abnormal heart rhythms;
- heart valve problems
- ischemic and hemorrhagic stroke;
- cerebrovascular disease: diseases of the blood vessels that supply the brain; and
- deep vein thrombosis and pulmonary embolism: blood clots in the veins of the leg, which can come lose and move to the heart and lungs.
At the American Headache Society’s annual scientific meeting in June 2014, a research poster was exhibited that significantly added to the body of evidence linking Migraine and cardiovascular diseases and events.
Poster Objectives: “To evaluate the association between migraine and incident cardiovascular disease (CVD), all-cause and CVD mortality in women.”
Background: “Migraine has been associated with increased risk of ischemic stroke in numerous studies. While some studies have suggested associations between migraine and any CVD, the evidence is less robust. In addition, the association between migraine and all-cause mortality remains inconclusive.”
- Data comes from a prospective cohort study (a study with groups of people who are linked and followed over time to watch for outcomes) among 115,541 Nurses Health Study II participants.
- Participant were between 25- and 42-years-old and free of angina and CVD at baseline (1989).
- Follow-up information was included through June 2011.
- The primary outcomes of the study were:
- total CVD, a combined endpoint of fatal and non-fatal myocardial infarction (MI) and stroke; and
- all-cause mortality (death from any cause).
- Secondary outcome measures included:
- coronary artery bypass/vascularization and angina,
- and CVD mortality.
- All outcome events have been confirmed after medical record review.
- Deaths were confirmed by review of autopsy reports, medical records and death certificates.
- On the baseline (1989) and two follow-up questionnaires (1991 and 1993), women were asked to indicate whether they have been diagnosed with migraine by a physician. Information on migraine aura was not available.
- A total of 17,531 (15.2%) women reported having been diagnosed with migraine by a physician.
- Over the period of more than 20 years of follow-up, 1,329 total CVD events occurred, and 2,490 women died.
- Compared with women without migraine, migraine was associated with increased risk for total CVD, stroke, angina/coronary revascularization procedures.
- There was also a significantly increased risk for all-cause mortality, which was driven by CVD mortality.
“Results of this large, prospective cohort study in women with over 20 years of follow-up indicate a consistent link between migraine and any cardiovascular disease event. In addition, our data indicate increased risk of all-cause mortality, particular cardiovascular mortality. Assuming causality, our result suggests that 13% of all deaths in the study were due to migraine. Migraine should be considered a risk factor for increased risk of CVD and mortality of any cause in women. Future targeted research is urgently warranted to identify preventive strategies to reduce these risks.”
Summary and Comments:
For several years, we’ve seen studies on the associations between migraine and cardiovascular and cerebrovascular disease and events such as stroke and myocardial infarction (heart attack). This is the first study to look at either association or causality of migraine in relation to deaths from all causes. Data from this type of study, which contained such a large number of participants and collected data over such a long time period is very strong.
The conclusion that 13% of all deaths of women in this study were due to migraine is startling and should be a wake-up call to women with migraine. Panic or feeing defeated by this statistic is neither warranted nor helpful. Rather, this wake-up call should motivate women with migraine to have constructive conversations with our doctors regarding what we can do to reduce modifiable risk factors and other actions we can take to be healthier and stronger.
Kurth, T.; Winter, A.; Rexrode, K.M. “Migraine and Risk of Cardiovascular Disease and Mortality in Women: Prospective Cohort Study.” Poster Presentation. 56th Annual Scientific Meeting; American Headache Society. Los Angeles. June, 2014.
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Teri Robert is a leading patient educator and advocate and the author of Living Well with Migraine Disease and Headaches. A co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association, she received the National Headache Foundation’s Patient Partners Award and a Distinguished Service Award from the American Headache Society. Teri can be found on her website, and blog, Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.