Triptan use as a function of cardiovascular risk. A population-based study: Research submission

Marcelo E. Bigal, Wendy Golden, Dawn Buse, Ya Ting Chen, Richard B. Lipton

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Aim.-To estimate the proportion of individuals with migraine using triptan therapy as a function of their cardiovascular (CV) profile and disease severity. Methods.-As a part of the American Migraine Prevalence and Prevention study, we identified migraineurs representative of the U.S. adult population. Triptan use was estimated as a function of presence of CV disease (CVD), of CV risk factors, and by level of migraine-related disability. Results.-Our sample consists of 6102 individuals with migraine. Compared with migraineurs without risk factors for CVD, triptans were significantly less likely to be used in individuals with diabetes (11.5% vs 18.3%, OR = 0.6, 95% CI = 0.5-0.7), hypertension (14.8%, OR = 0.8, 0.7-0.9) and by smokers (12.9%, OR = 0.7, 0.6-0.8). Similar findings were seen for individuals with established CVD. As contrasted to individuals without CVD, those with myocardial infarct (8.5% vs 18.5%, OR = 0.4, 0.3-0.7), stroke (7%, OR = 0.6, 0.3-0.9) and heart surgery (9.3%, OR = 0.5, 0.4-0.7) were less likely to use triptans. Use of triptan increased as a function of disability regardless of CVD status or presence of CV risk factors. Conclusion.-Triptan use is lower in those with vs without CV risk, suggesting that doctors and/or patients fear using triptans in individuals at risk to CVD. Furthermore, triptan use in those with established CVD increases with headache-related disability, suggesting that patients and providers balance risks and benefits. Additional and analytical data are needed on the safety of triptans in the setting of CVD risk. This study has not assessed adequacy of care.

Original languageEnglish (US)
Pages (from-to)256-263
Number of pages8
JournalHeadache
Volume50
Issue number2
DOIs
StatePublished - Feb 2010

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Tryptamines
Research
Population
Migraine Disorders
Cardiovascular Diseases
Thoracic Surgery
Fear
Headache
Cross-Sectional Studies
Stroke
Myocardial Infarction
Hypertension
Safety

Keywords

  • Cardiovascular disease
  • Migraine
  • Triptan

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Triptan use as a function of cardiovascular risk. A population-based study : Research submission. / Bigal, Marcelo E.; Golden, Wendy; Buse, Dawn; Chen, Ya Ting; Lipton, Richard B.

In: Headache, Vol. 50, No. 2, 02.2010, p. 256-263.

Research output: Contribution to journalArticle

Bigal, Marcelo E. ; Golden, Wendy ; Buse, Dawn ; Chen, Ya Ting ; Lipton, Richard B. / Triptan use as a function of cardiovascular risk. A population-based study : Research submission. In: Headache. 2010 ; Vol. 50, No. 2. pp. 256-263.
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abstract = "Aim.-To estimate the proportion of individuals with migraine using triptan therapy as a function of their cardiovascular (CV) profile and disease severity. Methods.-As a part of the American Migraine Prevalence and Prevention study, we identified migraineurs representative of the U.S. adult population. Triptan use was estimated as a function of presence of CV disease (CVD), of CV risk factors, and by level of migraine-related disability. Results.-Our sample consists of 6102 individuals with migraine. Compared with migraineurs without risk factors for CVD, triptans were significantly less likely to be used in individuals with diabetes (11.5{\%} vs 18.3{\%}, OR = 0.6, 95{\%} CI = 0.5-0.7), hypertension (14.8{\%}, OR = 0.8, 0.7-0.9) and by smokers (12.9{\%}, OR = 0.7, 0.6-0.8). Similar findings were seen for individuals with established CVD. As contrasted to individuals without CVD, those with myocardial infarct (8.5{\%} vs 18.5{\%}, OR = 0.4, 0.3-0.7), stroke (7{\%}, OR = 0.6, 0.3-0.9) and heart surgery (9.3{\%}, OR = 0.5, 0.4-0.7) were less likely to use triptans. Use of triptan increased as a function of disability regardless of CVD status or presence of CV risk factors. Conclusion.-Triptan use is lower in those with vs without CV risk, suggesting that doctors and/or patients fear using triptans in individuals at risk to CVD. Furthermore, triptan use in those with established CVD increases with headache-related disability, suggesting that patients and providers balance risks and benefits. Additional and analytical data are needed on the safety of triptans in the setting of CVD risk. This study has not assessed adequacy of care.",
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AB - Aim.-To estimate the proportion of individuals with migraine using triptan therapy as a function of their cardiovascular (CV) profile and disease severity. Methods.-As a part of the American Migraine Prevalence and Prevention study, we identified migraineurs representative of the U.S. adult population. Triptan use was estimated as a function of presence of CV disease (CVD), of CV risk factors, and by level of migraine-related disability. Results.-Our sample consists of 6102 individuals with migraine. Compared with migraineurs without risk factors for CVD, triptans were significantly less likely to be used in individuals with diabetes (11.5% vs 18.3%, OR = 0.6, 95% CI = 0.5-0.7), hypertension (14.8%, OR = 0.8, 0.7-0.9) and by smokers (12.9%, OR = 0.7, 0.6-0.8). Similar findings were seen for individuals with established CVD. As contrasted to individuals without CVD, those with myocardial infarct (8.5% vs 18.5%, OR = 0.4, 0.3-0.7), stroke (7%, OR = 0.6, 0.3-0.9) and heart surgery (9.3%, OR = 0.5, 0.4-0.7) were less likely to use triptans. Use of triptan increased as a function of disability regardless of CVD status or presence of CV risk factors. Conclusion.-Triptan use is lower in those with vs without CV risk, suggesting that doctors and/or patients fear using triptans in individuals at risk to CVD. Furthermore, triptan use in those with established CVD increases with headache-related disability, suggesting that patients and providers balance risks and benefits. Additional and analytical data are needed on the safety of triptans in the setting of CVD risk. This study has not assessed adequacy of care.

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