Women with migraine face increased risk for cardiovascular events and CV mortality, according to a large prospective study in The BMJ.
In the Nurses’ Health Study II, over 115,000 women aged 25 to 42 without angina or CV disease reported whether they’d ever been diagnosed with migraine and then were followed for roughly 20 years. Some 15% reported migraine at baseline.
During follow-up, roughly 1300 major CV events and 220 CV deaths occurred. Compared with women without migraine, those with migraine had significantly increased risks for myocardial infarction (adjusted hazard ratio, 1.4), stroke (HR, 1.6), angina/revascularization (HR, 1.7), and cardiovascular mortality (HR, 1.4). Findings were similar regardless of age, hormone therapy use, oral contraceptive use, smoking status, or hypertension.
Information about migraine aura was not available — an important limitation, the authors and editorialists note, given that prior research suggested that a migraine-stroke association was largely limited to a subgroup with aura.
Dr. Eleanor Bimla Schwarz of NEJM Journal Watch Women’s Health weighed in: “We have known for years that women with migraines have increased risk of stroke. The question that remains unanswered is at what age women with migraines should start daily aspirin to lower their risk of cardiovascular disease.”