Migraine and cardiovascular disease

A population-based study

M. E. Bigal, T. Kurth, N. Santanello, D. Buse, W. Golden, Matthew S. Robbins, Richard B. Lipton

Research output: Contribution to journalArticle

194 Citations (Scopus)

Abstract

Objectives: Although the relationship between migraine and cardiovascular disease (CVD) has been studied, several questions remain unanswered. Herein we contrast the rate of diagnosed CVD as well as of risk factors for CVD in individuals with migraine with and without aura (MA and MO) and in controls. Methods: In this case-control study, migraineurs (n = 6,102) and controls (n = 5,243) were representative of the adult US population. Headache diagnosis was formally assigned using a validated mailed questionnaire which also obtained details on treatment, comorbidities, and other variables. CVD events were obtained based on self-reported medical diagnosis. Risk factors for CVD and modified Framingham scores were computed. Results: In unadjusted analyses, migraine overall and MA were associated with myocardial infarction, stroke, and claudication, and MO was associated with myocardial infarction and claudication. Migraineurs were more likely than controls to have a medical diagnosis of diabetes (12.6% vs 9.4%, odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2-1.6), hypertension (33.1% vs 27.5%, OR 1.4, 95% CI 1.3-1.6), and high cholesterol (32.7% vs 25.6%, OR 1.4, 95% CI 1.3-1.5). Risk was highest in MA, but remained elevated in MO. Framingham scores were significantly higher in MO and MA than in controls. After adjustments (gender, age, disability, treatment, CVD risk factors), migraine remained significantly associated with myocardial infarction (OR 2.2, 95% CI 1.7-2.8), stroke (OR 1.5, 95% CI 1.2-2.1), and claudication (OR 2.69, 95% CI 1.98-3.23). Conclusion: Both migraine with and without aura are associated with cardiovascular disease (CVD) and with risk factors for CVD. However, since our sample size is large, the clinical relevance of the differences is yet to be established.

Original languageEnglish (US)
Pages (from-to)628-635
Number of pages8
JournalNeurology
Volume74
Issue number8
DOIs
StatePublished - Feb 2010

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Migraine Disorders
Cardiovascular Diseases
Odds Ratio
Confidence Intervals
Population
Migraine without Aura
Migraine with Aura
Myocardial Infarction
Stroke
Social Adjustment
Sample Size
Headache
Case-Control Studies
Comorbidity
Cholesterol
Hypertension
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Migraine and cardiovascular disease : A population-based study. / Bigal, M. E.; Kurth, T.; Santanello, N.; Buse, D.; Golden, W.; Robbins, Matthew S.; Lipton, Richard B.

In: Neurology, Vol. 74, No. 8, 02.2010, p. 628-635.

Research output: Contribution to journalArticle

Bigal, ME, Kurth, T, Santanello, N, Buse, D, Golden, W, Robbins, MS & Lipton, RB 2010, 'Migraine and cardiovascular disease: A population-based study', Neurology, vol. 74, no. 8, pp. 628-635. https://doi.org/10.1212/WNL.0b013e3181d0cc8b
Bigal ME, Kurth T, Santanello N, Buse D, Golden W, Robbins MS et al. Migraine and cardiovascular disease: A population-based study. Neurology. 2010 Feb;74(8):628-635. https://doi.org/10.1212/WNL.0b013e3181d0cc8b
Bigal, M. E. ; Kurth, T. ; Santanello, N. ; Buse, D. ; Golden, W. ; Robbins, Matthew S. ; Lipton, Richard B. / Migraine and cardiovascular disease : A population-based study. In: Neurology. 2010 ; Vol. 74, No. 8. pp. 628-635.
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abstract = "Objectives: Although the relationship between migraine and cardiovascular disease (CVD) has been studied, several questions remain unanswered. Herein we contrast the rate of diagnosed CVD as well as of risk factors for CVD in individuals with migraine with and without aura (MA and MO) and in controls. Methods: In this case-control study, migraineurs (n = 6,102) and controls (n = 5,243) were representative of the adult US population. Headache diagnosis was formally assigned using a validated mailed questionnaire which also obtained details on treatment, comorbidities, and other variables. CVD events were obtained based on self-reported medical diagnosis. Risk factors for CVD and modified Framingham scores were computed. Results: In unadjusted analyses, migraine overall and MA were associated with myocardial infarction, stroke, and claudication, and MO was associated with myocardial infarction and claudication. Migraineurs were more likely than controls to have a medical diagnosis of diabetes (12.6{\%} vs 9.4{\%}, odds ratio [OR] 1.4, 95{\%} confidence interval [CI] 1.2-1.6), hypertension (33.1{\%} vs 27.5{\%}, OR 1.4, 95{\%} CI 1.3-1.6), and high cholesterol (32.7{\%} vs 25.6{\%}, OR 1.4, 95{\%} CI 1.3-1.5). Risk was highest in MA, but remained elevated in MO. Framingham scores were significantly higher in MO and MA than in controls. After adjustments (gender, age, disability, treatment, CVD risk factors), migraine remained significantly associated with myocardial infarction (OR 2.2, 95{\%} CI 1.7-2.8), stroke (OR 1.5, 95{\%} CI 1.2-2.1), and claudication (OR 2.69, 95{\%} CI 1.98-3.23). Conclusion: Both migraine with and without aura are associated with cardiovascular disease (CVD) and with risk factors for CVD. However, since our sample size is large, the clinical relevance of the differences is yet to be established.",
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AU - Robbins, Matthew S.

AU - Lipton, Richard B.

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N2 - Objectives: Although the relationship between migraine and cardiovascular disease (CVD) has been studied, several questions remain unanswered. Herein we contrast the rate of diagnosed CVD as well as of risk factors for CVD in individuals with migraine with and without aura (MA and MO) and in controls. Methods: In this case-control study, migraineurs (n = 6,102) and controls (n = 5,243) were representative of the adult US population. Headache diagnosis was formally assigned using a validated mailed questionnaire which also obtained details on treatment, comorbidities, and other variables. CVD events were obtained based on self-reported medical diagnosis. Risk factors for CVD and modified Framingham scores were computed. Results: In unadjusted analyses, migraine overall and MA were associated with myocardial infarction, stroke, and claudication, and MO was associated with myocardial infarction and claudication. Migraineurs were more likely than controls to have a medical diagnosis of diabetes (12.6% vs 9.4%, odds ratio [OR] 1.4, 95% confidence interval [CI] 1.2-1.6), hypertension (33.1% vs 27.5%, OR 1.4, 95% CI 1.3-1.6), and high cholesterol (32.7% vs 25.6%, OR 1.4, 95% CI 1.3-1.5). Risk was highest in MA, but remained elevated in MO. Framingham scores were significantly higher in MO and MA than in controls. After adjustments (gender, age, disability, treatment, CVD risk factors), migraine remained significantly associated with myocardial infarction (OR 2.2, 95% CI 1.7-2.8), stroke (OR 1.5, 95% CI 1.2-2.1), and claudication (OR 2.69, 95% CI 1.98-3.23). Conclusion: Both migraine with and without aura are associated with cardiovascular disease (CVD) and with risk factors for CVD. However, since our sample size is large, the clinical relevance of the differences is yet to be established.

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