Migraines May Be Key Risk Factor for Cardiovascular Diseases

Migraines may be an important risk factor for several cardiovascular diseases, apart from stroke and heart attacks, according to a recent study published in BMJ.

Although it is already known that migraine is associated with ischemic stroke and myocardial infarction, the associations with other cardiovascular diseases and risks are less well known, according to the study researchers. However, the findings indicate that migraines may be linked to other cardiovascular diseases as well.

In the study, the researchers examined the risks of myocardial infarction, ischemic and hemorrhagic stroke, peripheral artery disease, venous thromboembolism, atrial fibrillation, and heart failure in patients with first time diagnosis of migraine and compared with the general population.

The researchers identified patients based on recorded inpatient, outpatient, and emergency department diagnoses in the Danish National Patient Registry, excluding patients with a migraine diagnosis before 1995 or with previous cardiovascular disease.

Overall, the migraine cohort included 51,032 individuals and the matched general population cohort included 510,320. Of the migraine group, 2451 patients had 1 cardiovascular event and 575 patients had more than 1 cardiovascular event. The researchers concluded that, along with being associated with myocardial infarction and stroke, migraine also increased risks of venous thromboembolism and atrial fibrillation.

Additionally, the risk of cardiovascular disease was highest during the first year after diagnosis, with an eightfold increased risk of ischemic and hemorrhagic stroke and a twofold increased risk of myocardial infarction, venous thromboembolism, and atrial fibrillation. Over the long term, migraine remained associated with these cardiovascular diseases. The researchers did not find any association between migraine and heart failure or peripheral artery disease.

The associations were stronger in patients who had migraines with aura than in those who did not have aura, and in women than in men.

Although overall absolute risks were low, the findings indicate that migraine should be considered a risk factor for most cardiovascular diseases, according to the researchers. They noted that current migraine guidelines do not recommend use of anticlotting medications such as aspirin for treatment, but health care providers should consider whether patients at higher risk of heart disease would benefit from anticoagulant treatment.

Reference

Adelborg K, Szepligeti SK, Holland-Bill L, et al. Migraine and risk of cardiovascular disease: Danish population based matched cohort study. BMJ. 2018; 360:k96 . DOI: 10.1136/bmj.k96