PMID- 29386181
OWN - NLM
STAT- MEDLINE
DCOM- 20180305
LR  - 20181113
IS  - 1756-1833 (Electronic)
IS  - 0959-8138 (Linking)
VI  - 360
DP  - 2018 Jan 31
TI  - Migraine and risk of cardiovascular diseases: Danish population based matched
      cohort study.
PG  - k96
LID - 10.1136/bmj.k96 [doi]
AB  - OBJECTIVE: To examine the risks of myocardial infarction, stroke (ischaemic and
      haemorrhagic), peripheral artery disease, venous thromboembolism, atrial
      fibrillation or atrial flutter, and heart failure in patients with migraine and
      in a general population comparison cohort. DESIGN: Nationwide, population based
      cohort study. SETTING: All Danish hospitals and hospital outpatient clinics from 
      1995 to 2013. PARTICIPANTS: 51 032 patients with migraine and 510 320 people from
      the general population matched on age, sex, and calendar year. MAIN OUTCOME
      MEASURES: Comorbidity adjusted hazard ratios of cardiovascular outcomes based on 
      Cox regression analysis. RESULTS: Higher absolute risks were observed among
      patients with incident migraine than in the general population across most
      outcomes and follow-up periods. After 19 years of follow-up, the cumulative
      incidences per 1000 people for the migraine cohort compared with the general
      population were 25 v 17 for myocardial infarction, 45 v 25 for ischaemic stroke, 
      11 v 6 for haemorrhagic stroke, 13 v 11 for peripheral artery disease, 27 v 18
      for venous thromboembolism, 47 v 34 for atrial fibrillation or atrial flutter,
      and 19 v 18 for heart failure. Correspondingly, migraine was positively
      associated with myocardial infarction (adjusted hazard ratio 1.49, 95% confidence
      interval 1.36 to 1.64), ischaemic stroke (2.26, 2.11 to 2.41), and haemorrhagic
      stroke (1.94, 1.68 to 2.23), as well as venous thromboembolism (1.59, 1.45 to
      1.74) and atrial fibrillation or atrial flutter (1.25, 1.16 to 1.36). No
      meaningful association was found with peripheral artery disease (adjusted hazard 
      ratio 1.12, 0.96 to 1.30) or heart failure (1.04, 0.93 to 1.16). The
      associations, particularly for stroke outcomes, were stronger during the short
      term (0-1 years) after diagnosis than the long term (up to 19 years), in patients
      with aura than in those without aura, and in women than in men. In a subcohort of
      patients, the associations persisted after additional multivariable adjustment
      for body mass index and smoking. CONCLUSIONS: Migraine was associated with
      increased risks of myocardial infarction, ischaemic stroke, haemorrhagic stroke, 
      venous thromboembolism, and atrial fibrillation or atrial flutter. Migraine may
      be an important risk factor for most cardiovascular diseases.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not
      already granted under a licence) please go to
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Adelborg, Kasper
AU  - Adelborg K
AD  - Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
      kade@clin.au.dk.
FAU - Szepligeti, Szimonetta Komjathine
AU  - Szepligeti SK
AD  - Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
FAU - Holland-Bill, Louise
AU  - Holland-Bill L
AD  - Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
FAU - Ehrenstein, Vera
AU  - Ehrenstein V
AD  - Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
FAU - Horvath-Puho, Erzsebet
AU  - Horvath-Puho E
AD  - Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
FAU - Henderson, Victor W
AU  - Henderson VW
AD  - Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
AD  - Department of Health Research and Policy (Epidemiology), Stanford University,
      Stanford, CA, USA.
AD  - Department of Neurology and Neurological Sciences, Stanford University, Stanford,
      CA, USA.
FAU - Sorensen, Henrik Toft
AU  - Sorensen HT
AD  - Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
AD  - Department of Health Research and Policy (Epidemiology), Stanford University,
      Stanford, CA, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180131
PL  - England
TA  - BMJ
JT  - BMJ (Clinical research ed.)
JID - 8900488
SB  - AIM
SB  - IM
CIN - BMJ. 2018 Jan 31;360:k275. PMID: 29386182
CIN - Nat Rev Neurol. 2018 Apr;14(4):194-195. PMID: 29449698
MH  - Adult
MH  - Atrial Fibrillation/epidemiology/etiology
MH  - Body Mass Index
MH  - Cardiovascular Diseases/epidemiology/*etiology
MH  - Cohort Studies
MH  - Comorbidity
MH  - Denmark/epidemiology
MH  - Female
MH  - Heart Failure/epidemiology/etiology
MH  - Humans
MH  - Incidence
MH  - Intracranial Hemorrhages/epidemiology/etiology
MH  - Male
MH  - Middle Aged
MH  - Migraine Disorders/*complications/diagnosis/epidemiology
MH  - Myocardial Infarction/epidemiology/*etiology
MH  - Outcome Assessment (Health Care)
MH  - Peripheral Arterial Disease/epidemiology/etiology
MH  - Prospective Studies
MH  - Risk Factors
MH  - Smoking/epidemiology
MH  - Stroke/epidemiology/*etiology
MH  - Venous Thromboembolism/epidemiology/etiology
PMC - PMC5791041
COIS- Competing interests: All authors have completed the ICMJE uniform disclosure form
      at http://www.icmje.org/coi_disclosure.pdf (available on request from the
      corresponding author) and declare: no support from any organisation for the
      submitted work other than that detailed above; no financial relationships in the 
      previous three years with any organisations that might have an interest in the
      submitted work; and no other relationships or activities that could appear to
      have influenced the submitted work.
EDAT- 2018/02/02 06:00
MHDA- 2018/03/06 06:00
CRDT- 2018/02/02 06:00
PHST- 2018/02/02 06:00 [entrez]
PHST- 2018/02/02 06:00 [pubmed]
PHST- 2018/03/06 06:00 [medline]
AID - 10.1136/bmj.k96 [doi]
PST - epublish
SO  - BMJ. 2018 Jan 31;360:k96. doi: 10.1136/bmj.k96.