Heart disease and stroke are the most common cardiovascular diseases (CVD), and together account for nearly 40 percent of all annual deaths in the U.S. The link between CVD -- especially stroke -- and migraine disease has been studied, but until early 2006, there had been no conclusive research to confirm or rule out a direct connection between overall CVD and migraine disease. At that time the Women's Health Study provided compelling evidence of increased risk of cardiovascular disease in women over 45 with migraine with aura. (See
Migraine With Aura Linked To Cardiovascular Disease.)
Study objective
At the American Heart Association Scientific Session in November 2006, researchers presented results of a study that investigated the possible connection between migraine and risks of overall and specific CVD in middle-aged men.
Study methods
The Physician's Health Study was a study of 20,084 men. When they entered the study in the early 1980s, the men ranged from age 40 to 84, and were free of CVD, cancer and other major illness. To ensure study accuracy, 1,987 men who did not answer the migraine screening questions were excluded. Participants completed questionnaires at the start of the study, six months later, and then annually. The questionnaires collected demographic and lifestyle information, as well as medical information.Study results
Of the 20,084 participants, a total of 1,449 men (seven percent) reported migraine, and 434 reported migraine four or more times. Compared to men who did not report migraine, those who did report migraine disease:- Were younger
- Were more likely to report a history of hypertension (high blood pressure)
- Were less likely to currently smoke cigarettes and regularly drink alcohol
- Were more likely to report a history of elevated cholesterol of 240mg/dL or higher.
Study conclusions
The study’s author, Dr. Tobias Kurth, and colleagues concluded:
"In this large prospective cohort of apparently healthy men, migraine was associated with risk of major CVD, which was driven by an increased risk of myocardial infarction."
In his presentation to the American Heart Association, Kurth said:
"The attributable risk is fairly low, so I think people should certainly not panic if they have a migraine attack that they’ll have a heart attack the next day. We know much more about major risk
factors and we should certainly emphasize and modify those. At this point, there’s no data that would support to change any treatment of migraine or anything else for migraineurs at this point."
Implications for Migraine Disease Patients
The results of this study were very similar to Kurth et al's study of migraine and cardiovascular disease in women, which showed an increased risk of CVD in women who have migraine with aura. As in the women's study, the specific link between migraine disease and CVD is still unclear. But certainly, CVD risk factors such as high cholesterol, high blood pressure, family history of CVD, smoking, lack of exercise, may be contributing to migraine disease. The link may also be related to inflammatory issues, the genetics of CVD and migraine disease, or a combination of these issues. Additional research should focus on better identifying how these diseases are related.
This study clearly offers incentive for patients and physicians to be more vigilant about cardiovascular risk factors that can be changed or eliminated such as high cholesterol, smoking, high blood pressure, and lack of exercise. It's also incentive for studies to determine if there are medications that can be used for two purposes -- to prevent migraine attacks and reduce CVD risk.
While the increased risk translates to just two major CVD events per 10,000 men per year, heart disease is already epidemic in the U.S. If you have migraine disease, this study gives you an added reason to talk to your doctor about your heart health, and what you can do together to help lower your risk factors and prevent heart disease.
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Resources:
"Heart Disease and Stroke: The Nation’s Leading Killers." Centers for Disease Control and Prevention. 2006.
Kurth, Tobias, MD, ScD; Gaziano, J. Michael, MD, MPH; Cook, Nancy R., ScD; Bubes, Vadim, PhD; Logroscino, Giancarlo, MD, PhD; Diener, Hans-Christoph, MD, PhD; Buring, Julie E., ScD. (2006) "Migraine is Associated with Increased Risk of Cardiovascular Disease in Men." Platform presentation. American Heart Association Scientific Session. November 15, 2006, Chicago, Illinois.
HealthDay. "Migraines Linked to Heart Risk in Men." Medline Plus. November 15, 2006.
Physicians Health Study
http://phs.bwh.harvard.edu/
