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February 2018

Migraine linked to increased cardiovascular risk

Migraine is associated with increased risks of cardiovascular problems including heart attacks, stroke, blood clots and an irregular heart rate, say researchers in a study published by The BMJ.

Although the absolute risks were low, the findings suggest that ‘migraine should be considered a potent and persistent risk factor for most cardiovascular diseases in both men and women,’ say the authors.

Around one billion people worldwide are affected by migraine. It has considerable impact on quality of life and imposes a substantial burden on society.

This study aimed to examine the risks of heart conditions including heart attacks, stroke, peripheral artery disease, blood clots and fast and irregular heart rates in people who experience migraines compared with people who don’t.

They compared data over a 19-year period, from 1995 to 2013, from over 51,000 people who had been diagnosed with migraine with over 510,000 people who were migraine free.

The researchers found that migraine was positively associated with heart attack, stroke, blood clots and irregular heart rate, even after taking account of body mass index and smoking.

This was an observational study, so no firm conclusions can be drawn about cause and effect, but possible explanations may be that people with migraine often use anti-inflammatory drugs, which are associated with increased risks of cardiovascular events, while immobility during migraine attacks may increase the risk of thromboembolism.

They note that current guidelines do not recommend use of anti-clotting drugs such as aspirin to treat migraine, but call on clinicians to ‘consider whether patients at particularly high risk of heart disease would benefit from anticoagulant treatment’.

‘We now have plenty of evidence that migraine should be taken seriously as a strong cardiovascular risk marker but action to reduce risk is long overdue,’ argue Professor Tobias Kurth and colleagues in a linked editorial.

Adelborg K, et al. BMJ 2018;360:k96

February 2018