Abstract

Background: TIAs and migraines have both been found to increase the risk of ischemic strokes. The risk for ischemic strokes may be further increased in patients with both of these risk factors. Objective: To compare the risk of ischemic strokes in women with and without a history of migraine following a TIA. Methods: The Observational Study (OS) of the Women’s Health Initiative (WHI) was the observational component of the WHI Study. We analyzed the 93,676 women aged 50-79 years, who participated in the OS over a period of 12±1 years. We determined the risk of incident ischemic stroke following TIAs in women with and without history of migraine. A logistic regression analysis was used to determine the differential risk of ischemic stroke in women with and without history of migraine after adjusting for potential confounders. Results: A total of 133 of the 93676 women without history of migraine and 20 women with history of migraine from the same population developed ischemic strokes. Logistic regression analysis demonstrated that women without history of migraine had a higher odds of developing ischemic stroke [OR 1.9 (95%CI 1.5-2.5) p<.0001] compared with women without TIA after adjustments were made for age, systolic blood pressure, alcohol intake, carotid endarterectomy, DVT, pulmonary embolism, bleeding problems, oral contraceptive use, and hormone replacement therapy. There was not a higher risk of subsequent ischemic stroke among women with migraine history after TIA [OR 1.5 (95%CI 0.7-3.3); p =0.3] Conclusions: The risk of ischemic stroke is lower following TIA in women with migraine history (compared with those without migraine) suggesting potentially different pathophysiology in such women.

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