Migraine headache, particularly migraine with aura, is associated with increased risk for cardiovascular disease and cerebrovascular events, including ischemic stroke. In light of the high prevalence of migraine headache, this association should be further investigated, according to a review published in the Journal of the American Heart Association.
Other than the characteristic headache, migraine may be associated with transient focal neurology symptoms (eg, aura) that usually persist for less than an hour. There is a wide inter-individual and intra-individual variability in the frequency of migraine attacks. Migraine is most common in women aged 25 to 55 years, and the prevalence decreases after the fifth decade of life.
There are several possible mechanisms for the increased risk for cardiovascular and cerebrovascular disease in patients with migraine, including higher prevalence of hypertension and hyperlipidemia, generalized endothelial dysfunction and increased platelet aggregation, higher prevalence of patent foramen ovale (PFO), and the effect of medications used to treat these patients.
Previous studies have reported gender differences in migraine characteristics, as the disease is more prevalent and frequently more severe in women. It is believed that fluctuations in hormone levels, particularly estrogen, may be responsible for these gender differences.
Many studies have reported an association between migraine and cardiovascular and cerebrovascular disease, with a more robust association in cases of migraine with aura. There are data associating migraine with aura with an increased risk for ischemic stroke, myocardial infarction, cardiovascular mortality, as well as venous thromboembolism and peripheral artery disease.
As noted, PFO may be more common in patients with migraine. Several studies have suggested that closure of PFO may be beneficial and reduce migraine attack frequency. However, as this was not the primary outcome of the studies, routine PFO closure for migraine should not be recommended at this point.
While there are many studies reporting an association between migraine and cardiovascular and cerebrovascular events, the rate of events in all these studies was low. On the other hand, due to the high prevalence of migraine worldwide, this still translates into a substantial increase in population risk.
At this point, there are no established recommendations aimed at reducing cardiovascular risk in patients with migraine. Evidence of potential benefit of anti-platelet, beta-blocker, and statin therapy in patients with migraine are lacking. Moreover, limited data are available on the effect of controlling migraine symptoms on cardiovascular events.
While triptans have not been shown to increase cardiovascular risk in patients with migraine, nonsteroidal anti-inflammatory drugs use should be limited to acute migraine episodes, as chronic use may be associated with increased cardiovascular risk.
Patients with migraine should be counseled about a healthy lifestyle, including regular physical activity, smoking cessation, blood pressure control, and weight loss.
To date, there has been no established therapy to lower cardiovascular risk among women with migraine. Physicians should inquire about migraine history when assessing the cardiovascular risk of women, concluded the researchers.
Reference
Elgendy IY, Nadeau SE, Bairey Merz CN, Pepine CJ. Migraine headache: an under-appreciated risk factor for cardiovascular disease in women. J Am Heart Assoc. 2019;8(22):e014546. doi:10.1161/JAHA.119.014546
This article originally appeared on Neurology Advisor
Originally posted here:
Migraine Headache and Risk for Cardiovascular and Cerebrovascular Events - The Cardiology Advisor
- ST-Segment Elevation Myocardial Infarction - verywell.com [Last Updated On: May 12th, 2018] [Originally Added On: May 12th, 2018]
- Myocardial infarction (Heart Attack) - Health Facts [Last Updated On: June 21st, 2018] [Originally Added On: June 21st, 2018]
- Heart Attack and Acute Coronary Syndrome - Lab Tests Online [Last Updated On: June 21st, 2018] [Originally Added On: June 21st, 2018]
- Myocardial Infarction - ECGpedia [Last Updated On: September 21st, 2018] [Originally Added On: September 21st, 2018]
- Myocardial Infarction Clinical Presentation: History ... [Last Updated On: September 25th, 2018] [Originally Added On: September 25th, 2018]
- Myocardial infarction diagnosis - Wikipedia [Last Updated On: September 25th, 2018] [Originally Added On: September 25th, 2018]
- Myocardial Infarction Treatment & Management: Approach ... [Last Updated On: October 9th, 2018] [Originally Added On: October 9th, 2018]
- Myocardial infarction - Simple English Wikipedia, the free ... [Last Updated On: October 18th, 2018] [Originally Added On: October 18th, 2018]
- ST-Segment Elevation Myocardial Infarction [Last Updated On: October 18th, 2018] [Originally Added On: October 18th, 2018]
- ECG localization of myocardial infarction / ischemia and ... [Last Updated On: October 18th, 2018] [Originally Added On: October 18th, 2018]
- Heart Attack (Myocardial Infarction) Symptoms | Cleveland Clinic [Last Updated On: November 15th, 2018] [Originally Added On: November 15th, 2018]
- Myocardial Infarction (Heart Attack) Ischemia Pathophysiology, ECG, Nursing, Signs, Symptoms Part 1 [Last Updated On: November 15th, 2018] [Originally Added On: November 15th, 2018]
- Myocardial Infarction (MI) NCLEX Questions [Last Updated On: November 30th, 2018] [Originally Added On: November 30th, 2018]
- Myocardial Infarction NCLEX Review (Part 1) [Last Updated On: December 3rd, 2018] [Originally Added On: December 3rd, 2018]
- Acute Myocardial Infarction, Myocardial infection. Patient [Last Updated On: December 4th, 2018] [Originally Added On: December 4th, 2018]
- Heart Attack | Myocardial Infarction | MedlinePlus [Last Updated On: December 16th, 2018] [Originally Added On: December 16th, 2018]
- Heart Attack (Myocardial Infarction) - medicinenet.com [Last Updated On: December 17th, 2018] [Originally Added On: December 17th, 2018]
- Myocardial infarction (acute): Early rule out using high ... [Last Updated On: December 20th, 2018] [Originally Added On: December 20th, 2018]
- Conditions We Treat: Myocardial Infarction | Johns Hopkins ... [Last Updated On: December 23rd, 2018] [Originally Added On: December 23rd, 2018]
- Myocardial Infarction - Heart Home Page [Last Updated On: December 25th, 2018] [Originally Added On: December 25th, 2018]
- Myocardial infarction: signs symptoms and treatment ... [Last Updated On: December 25th, 2018] [Originally Added On: December 25th, 2018]
- ECGs in Acute Myocardial Infarction - ACLS Medical Training [Last Updated On: December 25th, 2018] [Originally Added On: December 25th, 2018]
- Myocardial Infarction - Eccles Health Sciences Library [Last Updated On: December 27th, 2018] [Originally Added On: December 27th, 2018]
- Myocardial Infarction: Practice Essentials, Background ... [Last Updated On: December 27th, 2018] [Originally Added On: December 27th, 2018]
- Myocardial infarction - Wikipedia [Last Updated On: December 27th, 2018] [Originally Added On: December 27th, 2018]
- Nursing Care Plan for Myocardial Infarction | NRSNG [Last Updated On: December 29th, 2018] [Originally Added On: December 29th, 2018]
- Cardiovascular disease - Myocardial infarction | Britannica.com [Last Updated On: January 11th, 2019] [Originally Added On: January 11th, 2019]
- Heart Attack (Myocardial Infarction) - Cedars-Sinai [Last Updated On: January 11th, 2019] [Originally Added On: January 11th, 2019]
- Top 5 MI ECG Patterns You Must Know | LearntheHeart.com [Last Updated On: January 11th, 2019] [Originally Added On: January 11th, 2019]
- Anterior Myocardial Infarction LITFL ECG Library Diagnosis [Last Updated On: January 11th, 2019] [Originally Added On: January 11th, 2019]
- Electrocardiography in myocardial infarction - Wikipedia [Last Updated On: January 11th, 2019] [Originally Added On: January 11th, 2019]
- Myocardial Infarction Therapeutics Market, Share, Growth ... [Last Updated On: March 13th, 2019] [Originally Added On: March 13th, 2019]
- Heart Attack (Myocardial Infarction) - Drugs.com [Last Updated On: April 20th, 2019] [Originally Added On: April 20th, 2019]
- STEMI (ST Elevation Myocardial Infarction): diagnosis ... [Last Updated On: April 20th, 2019] [Originally Added On: April 20th, 2019]
- Heart attack - Symptoms and causes - Mayo Clinic [Last Updated On: April 20th, 2019] [Originally Added On: April 20th, 2019]
- Cardiovascular models including myocardial infarction ... [Last Updated On: April 27th, 2019] [Originally Added On: April 27th, 2019]
- Myocardial infarction - Osmosis Video Library [Last Updated On: May 1st, 2019] [Originally Added On: May 1st, 2019]
- Myocardial Infarction [Last Updated On: September 17th, 2019] [Originally Added On: September 17th, 2019]
- Creatinine Rises After RAS Inhibitor Initiation Tied to Worse Outcomes - Renal and Urology News [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Ventricular Tachycardia Treatment Market Growth in Technological Innovation, Competitive Landscape Mapping the Trends and Outlook - NewsVarsity [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- FDA Action Alert: Merck and Amarin - BioSpace [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Resverlogix Provides Update on BETonMACE Phase 3 Trial Toronto Stock Exchange:RVX - GlobeNewswire [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Marijuana Use Linked to Improved Acute-HF Hospital Survival - Medscape [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Population Health vs. Personalized Medicine: Lost in Translation? - American Council on Science and Health [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Bariatric Surgery Tied to Less MACE in Obesity, Diabetes - Medscape [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- A Novel Algorithm for Improving the Diagnostic Accuracy of Prehospital ST-Elevation Myocardial Infarction - DocWire News [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Shock and Awe: ARNI for Acute HF May Be Safely Started in ICU - Medscape [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Global Myocardial Infarction Treatment Market Will Reach USD 1726.3 million by end of 2022 - Market News Store [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Frequency and Factors Related to Not Receiving Acute Reperfusion Therapy in Patients with ST Elevation Myocardial Infarction; A Single Specialty... [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Research Offers 10-Year Forecast on Myocardial Infarction Treatment Market - Rapid News Network [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- University of Colorado study suggests Cannabis aids in surviving heart... - Communities Digital News [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- SRH part of regional system award recognizing care for heart attacks - Index-Journal [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- TherOx Announces Key SuperSaturated Oxygen Therapy Presentations at TCT 2019 - Yahoo Finance [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Incidence, Characteristics and Outcomes in Very Young Patients with ST Segment Elevation Myocardial Infarction - DocWire News [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Health Recovery After Acute MI Similar in Young Adults With and Without Diabetes - The Cardiology Advisor [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Rapid Diagnosis Protocol for Chest Pain Does Not Improve Outcomes - Diagnostic and Interventional Cardiology [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Diagnosis of Myocardial Infarction At Autopsy: AECVP Reappraisal in the Light of the Current Clinical Classification - DocWire News [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Global Myocardial Infarction Drug Market 2019 BioCardia, Inc., Biscayne Pharmaceuticals, Inc., Capricor Therapeutics, Inc., Cell - Market News Times [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Abiomed to Highlight Importance of Optimal PCI Treatment to Improve Outcomes for High-Risk Patients at TCT 2019 - Yahoo Finance [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- ENTRUST-AF PCI Supports Safety of Dual Therapy With Edoxaban - Medscape [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Preoperative opioid use leads to perioperative consequences in foot and ankle surgery - Healio [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- CV, General Safety of Long-Term PPI Use Examined - The Cardiology Advisor [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Effect of Delayed vs Immediate Interventions in Transient STEMI - The Cardiology Advisor [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Cardiorenal Disease Is the Most Common CVD Manifestation in Patients With T2D - Endocrinology Advisor [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- DAPA-HF Published: 'Stunning Consistent Benefit With Dapagliflozin' - Medscape [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Geomagnetic Disturbances and Cardiovascular Mortality Risk - On Health - BMC Blogs Network [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- Reconsidering the Safety of Intravenous Thrombolysis for Ischemic Stroke After Recent Myocardial Infarction - Neurology Advisor [Last Updated On: September 19th, 2019] [Originally Added On: September 19th, 2019]
- The Lowdown on Lipoprotein(a) - Medscape [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- Protamine use found to significantly reduce reoperations for patients who undergo carotid endarterectomy - Vascular News [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- Left Main Treated With PCI or CABG Have Similar Outcomes at Five Years - Diagnostic and Interventional Cardiology [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- Sen. Sanders released from the hospital after heart attack - WXYZ [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- E-Selectin Gene Haplotypes are Associated with the Risk of Myocardial Infarction - DocWire News [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- BioVentrix Enrolls and Treats First Patient in REVIVE-HF European RCT for Ischemic Heart Failure Patients - P&T Community [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- Quantitative Flow Ratio guided Residual Functional SYNTAX Score for Risk Assessment in Patients with ST-Segment Elevation Myocardial Infarction... [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- Coronary Calcium Scan: The Role of Calcium Scoring in Preventing a First Myocardial Infarction - Consultant360 [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- Sanders plans to 'change the nature' of campaign after heart attack - New York Post [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- Early MI Linked to High Recurrent Events, Mortality - Medscape [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- Sudden Cardiac Arrest and Ventricular Arrhythmias following first type I Myocardial Infarction in the Contemporary Era - DocWire News [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- E-Cigarette Use and Myocardial Infarction - Physician's Weekly [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]
- Sen. Bernie Sanders had heart attack; chest pains diagnosed as myocardial infarction - KIRO Seattle [Last Updated On: October 9th, 2019] [Originally Added On: October 9th, 2019]