Migraine and cardiovascular disease

Possible mechanisms of interaction

M. E. Bigal, T. Kurth, H. Hu, N. Santanello, Richard B. Lipton

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Migraine, especially migraine with aura (MA), is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication, and cardiovascular mortality. The mechanisms which link migraine to ischemic vascular disease remain uncertain and are likely to be complex. Cortical spreading depression, the presumed substrate of aura, may directly predispose to brain lesions and that would explain why MA is consistently demonstrated as a risk factor for cerebral ischemia, while for migraine without aura (MO), the evidence is less consistent. Additionally, individuals with migraine have a higher prevalence of risk factors known to be associated with cardiovascular disease (CVD), including hypertension, diabetes, and hyperlipidemia. The increased prevalence of CVD risk factors is also higher for MA than for MO. Since the evidence linking migraine and CVD is getting robust, neurologists should be aware of this association. Individuals with MO seem to be at little increased risk of CVD. MA is associated with an increased risk of ischemic stroke and likely also for other ischemic CVD events. Accordingly, heightened vigilance is recommended for modifiable cardiovascular risk factors in migraineurs, especially with MA. Ultimately, it will be important to determine whether MA is a modifiable risk factor for CVD and if preventive medications for migraine or antiplatelet therapy might reduce the risk of CVD in patients with MA.

Original languageEnglish (US)
Pages (from-to)1864-1871
Number of pages8
JournalNeurology
Volume72
Issue number21
DOIs
StatePublished - May 26 2009

Fingerprint

Migraine with Aura
Migraine Disorders
Cardiovascular Diseases
Cortical Spreading Depression
Migraine without Aura
Brain
Hyperlipidemias
Brain Ischemia
Vascular Diseases
Blood Vessels
Epilepsy
Stroke
Myocardial Infarction
Hypertension
Mortality

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Migraine and cardiovascular disease : Possible mechanisms of interaction. / Bigal, M. E.; Kurth, T.; Hu, H.; Santanello, N.; Lipton, Richard B.

In: Neurology, Vol. 72, No. 21, 26.05.2009, p. 1864-1871.

Research output: Contribution to journalArticle

Bigal, M. E. ; Kurth, T. ; Hu, H. ; Santanello, N. ; Lipton, Richard B. / Migraine and cardiovascular disease : Possible mechanisms of interaction. In: Neurology. 2009 ; Vol. 72, No. 21. pp. 1864-1871.
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