What are the vascular risks associated with migraine headache?

Updated: Oct 21, 2019
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD  more...
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People who suffer from migraine headaches are more likely to also have cardiovascular or cerebrovascular disease (ie, stroke, myocardial infarction). [47] Reliable evidence comes from the Women's Health Study, which found that migraine with aura raised the risk of myocardial infarction by 91% and ischemic stroke by 108% and that migraine without aura raised both risks by approximately 25%. [48] Migraines during pregnancy are also linked to stroke and vascular diseases. [49]  A 2017 analysis of the Women's Health Study found that women who experience migraine headaches, particularly migraine without aura, may be at increased risk for hypertension. Compared with women without a history of migraine, those who experienced migraine with aura had about a 9% increased risk for hypertension while those who experienced migraine without aura had about a 21% increased risk. [50]

Migraine with aura for women in midlife has a statistically significant association with late-life vascular disease (infarcts) in the cerebellum. This association is not seen in migraine without aura. [51]

Results of a large, prospective cohort study in women indicate a consistent link between migraine and cardiovascular disease events, including cardiovascular mortality. Researchers analyzed data from more than 115,000 women, 15.2% (17,531) of whom reported a diagnosis of migraine. Over 20 years of follow-up, 1329 major cardiovascular disease events occurred and 223 women died from cardiovascular disease. After adjusting for the known risk factors, women with migraine had a significantly elevated risk for developing major cardiovascular disease (hazard ratio 1.50, 95% CI 1.33-1.69). The greatest increase in risk was for stroke (HR 1.62) and for angina/coronary revascularizations (HR 1.73). [52]

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