SAN DIEGO—Migraine with aura is a strong relative contributor to an increased risk of cardiovascular disease events in women, according to Tobias Kurth, MD, and colleagues. Reporting at the 65th Annual Meeting of the American Academy of Neurology, Dr. Kurth noted that although the combination of traditional vascular risk factors still shows the strongest contribution to cardiovascular disease occurrence, migraine with aura was a strong risk factor in a cohort of healthy women. Dr. Kurth is Director of Research at Inserm and the University of Bordeaux in France and Adjunct Associate Professor of Epidemiology at Brigham and Women’s Hospital, Harvard Medical School in Boston.
Dr. Kurth and colleagues conducted a prospective cohort study of 27,860 women ages 45 or older who were participating in the Women's Health Study, were free of cardiovascular disease at baseline, and for whom the researchers had self-reported information on migraine and lipid measurements. Women were followed for medical record–confirmed major cardiovascular disease (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular disease death). Multivariable standardization models were used to evaluate the contribution of migraine with aura to cardiovascular disease risk relative to other major vascular risk factors.
At baseline, 5,130 of the women reported migraine. Of these, 1,435 (40%) reported migraine with aura. During 15 years of follow-up, 1,030 major cardiovascular disease events were confirmed in the study cohort (overall incidence rate 2.4 per 1,000 women per year). A systolic blood pressure of 180 mm Hg or above was the greatest risk factor for cardiovascular disease (adjusted incidence rate of 9.8). Migraine with aura was the second strongest single contributor to major cardiovascular disease risk (incidence rate of 7.9) followed by diabetes (incidence rate 7.1), family history of premature myocardial infarction (incidence rate 5.4), current smoking (incidence rate 5.4), and BMI of 35 kg/m2 or above (incidence rate 5.3).
In relation to the Framingham risk score for coronary heart disease, women with migraine with aura had a 10-year risk of major CVD comparable with the 2% to 4% Framingham risk group, while women in the 10% or above risk group had the highest major cardiovascular disease risk (incidence rate 16.6).