Migraine May Double Risk of Heart Attack

Migraine sufferers are twice as likely to have heart attacks as people without migraine, according to a new study by researchers at Albert Einstein College of Medicine of Yeshiva University. The study, published in the online issue of Neurology, found that migraine sufferers also face increased risk for stroke and were more likely to have key risk factors for cardiovascular disease, including diabetes, high blood pressure, and high cholesterol.

“Migraine has been viewed as a painful condition that affects quality of life, but not as a threat to people’s overall health,” says lead investigator Richard B. Lipton, MD, senior study author and professor and vice chair in The Saul R. Korey department of neurology at Einstein. He also directs the Headache Center at Montefiore Medical Center, the University Hospital and Academic Medical Center for Einstein.

Lipton adds, “Our study suggests that migraine is not an isolated disorder and that, when caring for people with migraine, we should also be attentive to detecting and treating their cardiovascular risk factors.”

There are two major forms, migraine without aura and migraine with aura. Both forms involve pulsing or throbbing pain, pain on one side of the head, nausea or vomiting, or sensitivity to light or sound. Migraine with aura has additional neurological symptoms including flashing lights, zig-zag lines, or a graying out of vision.

Previous population studies found that migraine with aura is associated with heart disease and stroke, particularly in healthcare professionals over the age of 45. The Einstein study showed that both migraine with aura and migraine without aura are risk factors for heart disease and stroke in a broadly representative sample of the U.S. population, including people from all walks of life aged 18 to 80.

In the study, the researchers analyzed data on 6,102 people with migraine and 5,243 people without migraine. Participants completed questionnaires that asked about general health; headache frequency, severity, and symptoms; and a broad range of medically diagnosed cardiovascular symptoms and events. Data was collected as part of The American Migraine Prevalence and Prevention Study, a longitudinal, population-based study of U.S. headache sufferers.

Results showed that migraine sufferers were about twice as likely to have had a heart attack compared with people without migraine (4.1% of people with migraine compared with 1.9% of those without migraine). The heart-attack risk was higher for those whose migraine is accompanied by aura: a three-fold greater risk compared with people who didn’t suffer migraine.

The data also shows that people with migraine were about 50% more likely than controls to have diabetes, hypertension, and elevated cholesterol, all well-known cardiovascular risk factors. The study found that these risk factors may contribute—but do not fully explain—the increased risk of heart attack and stroke in persons with migraine. This finding suggests a possible mechanism linking migraine headaches and cardiovascular events: the functioning of the inner layer of blood vessels, known as the endothelium, may be compromised in vessels both inside and outside the brains of migraine sufferers.

“Migraine sufferers should not be alarmed by our findings,” says Lipton. “While we found an increased risk for cardiovascular problems, the percentage of people actually affected remains small. Overall, for example, only 4.1% of migraine sufferers had heart attacks. And while the risk of stroke was 60% higher for migraine sufferers than for the rest of the population, the percentage of migraine sufferers experiencing strokes was still quite low—2%.”

The main message of the study, says Lipton, is that migraine patients and their doctors should be particularly attentive to identifying and managing cardiovascular risk factors, such as high blood pressure, high cholesterol, obesity, and diabetes.

— Source: Albert Einstein College of Medicine of Yeshiva University