The association between migraine and cardiovascular events in women is modified by baseline vascular risk status

Abstract

Introduction: Migraine has been associated with increased risk of ischemic stroke, particularly in women [1–4]. This association is more evident for migraine with aura (MA) than for migraine without aura (MO) [1,5]. Neuroimaging studies have found higher prevalence of silent cerebellar infarcts in migraineurs compared with controls, and an increased number of white matter lesions in women with migraine [6]. Migraine also has been associated with an increased risk of cardiac ischemic events in both women and men [7,8]. Several mechanisms for these associations have been proposed, including vasospasm, endothelial dysfunction, and increased platelet aggregation [9,10]. In a large population-based study, migraine patients—in particular those with MA—were more likely to have unfavorable cardiovascular risk profi les compared with controls [11]. Patent foramen ovale, which is associated with increased risk of stroke in young adults, is twice as common in MA as in nonmigraine controls [12]. In this study, Kurth and colleagues examined whether the association between MA and cardiovascular events in women is modifi ed by the patient’s vascular risk status.