Women with migraine have a higher risk of cardiovascular disease and cardiovascular mortality, according to findings from a large, prospective cohort study with >20 years of follow-up. “In our study, migraine is associated with any cardiovascular outcome, that is, stroke, myocardial infarction, cardiovascular death, and coronary revascularization,” says Tobias Kurth, lead investigator of the study.

Kurth and colleagues analysed data from 115,541 women from the Nurses' Health Study II. At baseline in 1989, participants were aged 25–42 years, without cardiovascular disease, and 17,531 reported a diagnosis of migraine. 1,329 major cardiovascular disease events (myocardial infarction, stroke, or fatal cardiovascular disease) and 223 deaths from cardiovascular disease occurred during the 20-year follow-up.

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After adjusting for traditional vascular risk factors, women with migraine had an increased risk of major cardiovascular disease compared with women without migraine (HR 1.50, 95% CI 1.33–1.69). Migraine was also associated with an increased risk in individual outcomes (myocardial infarction, stroke, and angina or coronary revascularization) and death from cardiovascular disease. The associations were similar across subgroups (age, hypertension, postmenopausal hormone use, oral contraceptive use, or smoking status), but no information was available to allow analyses by migraine characteristics (aura, frequency, or migraine-specific medication).

migraine should be viewed as a marker for increased risk of cardiovascular disease

“Taken all together,” says Kurth, “migraine should be viewed as a marker for increased risk of cardiovascular disease.” However, the mechanisms underlying this association have not been identified. “So far, we do not even know if treating migraine reduces this risk,” Kurth points out. As a next step, the study investigators hope to assess how to reduce the higher risk of cardiovascular disease associated with migraine.