Migraines Associated with Risk of High Blood Pressure in Postmenopausal Women

Women who experience migraines prior to menopause may have an increased risk of developing high blood pressure after menopause, according to a new study published in Neurology.

“Migraine is a debilitating disorder, often resulting in multiple severe headaches a month and typically experienced more often by women than men,” said study author Gianluca Severi, PhD, of the French National Institute of Health and Medical Research, in the press release.

The study involved 56,202 women who did not have high blood pressure or cardiovascular disease when their menopause began. Of those, 46,659 women had never experienced a migraine and 9543 women had experienced a migraine. The participants were followed up to 20 years and completed health surveys every 2 to 3 years. By the end of the study, 11,030 women reported migraines, according to the authors.

“Migraine is most prevalent in women in the years before menopause,” Severi said in the press release. “After menopause, fewer women experience migraines. However, this is when the prevalence of high blood pressure in women increases.”

Severi noted that migraines are a risk factor for cardiovascular disease, so identifying whether migraines could be linked to an increased risk of high blood pressure after menopause was the goal of the study. During the study period, 12,501 women developed high blood pressure, including 9401 women with no migraine history and 3100 women with a history of migraines.

Notably, women with a history of migraines also developed high blood pressure at a younger age than women without a history of migraines. The average age of diagnosis for women without migraines was 65 years of age, compared to 63 years of age for women with migraines.

The investigators calculated the risk of developing high blood pressure using person-years, which represent both the number of people in the study and the amount of time each person spent in the study. During the 826,419 person-years in the study, there was an overall rate of 15 cases of high blood pressure diagnosed for every 1000 person-years. For women without a history of migraines, the rate was 14 cases for every 1000 person-years compared to 19 cases per 1000 person-years for women with migraines.

After adjusting for factors such as body mass index, physical activity levels, and family history of cardiovascular disease, the investigators found that women who had migraines before menopause had a 29% increased risk of developing high blood pressure after menopause. The risk of developing high blood pressure was similar in women with migraines either with or without aura.

“There are multiple ways in which migraine may be linked to high blood pressure,” Severi said in the press release. “People with migraine have been shown to have early signs of arterial stiffness. Stiffer, smaller vessels are not as capable of accommodating blood flow, resulting in pressure increases. It is also possible that associations could be due to genetics.”

The study did not show that migraines cause high blood pressure after menopause and only showed an association, according to the researchers.

“Since previous research shows migraine increases the likelihood of cardiovascular events, identification of additional risk factors such as the higher likelihood of high blood pressure among people with migraine could aid in individualized treatment or prevention,” Severi concluded in the press release. “Doctors may want to consider women with a history of migraine at a higher risk of high blood pressure.”

REFERENCE

Migraine Linked to Increased Risk of High Blood Pressure After Menopause [news release]. American Academy of Neurology; April 21, 2021. https://www.aan.com/PressRoom/Home/PressRelease/4888. Accessed April 22, 2021.