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Am J Med. 2017 Jan 18. pii: S0002-9343(17)30031-1. doi: 10.1016/j.amjmed.2016.12.028. [Epub ahead of print]

Migraine Headache and Long Term Cardiovascular Outcomes: An extended follow-up of the Women's Ischemia Syndrome Evaluation.

Author information

  • 1Department of Medicine, University of Florida, Gainesville, Florida. Electronic address: cecil.rambarat@medicine.ufl.edu.
  • 2Division of Cardiovascular Disease, Department of Medicine, University of Florida, Gainesville, Florida.
  • 3Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • 4Division of Cardiovascular Disease, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • 5Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania.
  • 6Rhode Island Hospital, Providence, Rhode Island.
  • 7Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
  • 8Divison of Heart and Vascular Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland.
  • 9Division of Cardiovascular Disease, Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.
  • 10Division of Cardiovascular Disease, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Electronic address: Bina.Ahmed@hitchcock.org.

Abstract

BACKGROUND:

The association between migraine headache and cardiovascular events has been inconsistent. This study determines the long-term risk of cardiovascular events among women with and without a history of migraine headache who were under evaluation for suspected myocardial ischemia in the Women's Ischemia Syndrome Evaluation (WISE).

METHODS:

The WISE is a National Heart, Lung and Blood Institute sponsored prospective, multicenter study which aims to improve myocardial ischemia evaluation in women. A total of 936 women presenting with symptoms of myocardial ischemia underwent structured data collection and coronary angiography. Information pertaining to migraine headache was available in 917 women. All-cause mortality data were available on all women for a median of 9.5 years and non-fatal cardiovascular event data were available on 888 women for a median of 6.5 years.

RESULTS:

A total of 224 (24.4%) women reported a history of migraine headache. Compared with women who did not report a history of migraine headache, women with a history of migraine headache had an increased adjusted risk of cardiovascular event (cardiovascular death, non-fatal myocardial infarction, heart failure or stroke) (HR 1.83 CI 1.22-2.75) at a median follow up of 6.5 years. This result was driven mainly by a two-fold increase in the risk of stroke (HR 2.33 CI 1.16-4.68).

CONCLUSION:

Among women being evaluated for ischemic heart disease, those reporting a history of migraine headache had increased risk of future cardiovascular events on long-term follow up. This risk was primarily driven by a more than two-fold increase in the risk of stroke.

KEYWORDS:

cardiovascular disease; migraine; mortality; stroke; women

PMID:
28109970
DOI:
10.1016/j.amjmed.2016.12.028
[PubMed - as supplied by publisher]
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