PHILADELPHIA – A history of migraine in postmenopausal women may not be linked to an increased risk for stroke, myocardial infarction, or composite cardiovascular disease (CVD) events, according to study results presented at the 61st Annual Scientific Meeting of the American Headache Society, held July 11-14 in Philadelphia, Pennsylvania.
The study included postmenopausal women age 50 to 79 years with no pre-existing CVD who were recruited from 40 US clinical centers between 1993 and 1998 and followed for 22 years (n=71,441). In this study, incident CVD events were defined as the earliest of any of the following CVD outcomes: myocardial infarction, stroke, angioplasty of coronary arteries, coronary bypass surgery, coronary heart disease, deep vein thrombosis, or pulmonary embolism. The risk for myocardial infarction and stroke (ischemic, hemorrhagic, or indeterminate) were also assessed separately. Migraine status was determined at baseline by self-reported clinician diagnosis. Cox proportional hazards regression models were used to determine whether migraine status was a predictor of incident CVD.
Of all participants, 10.7% (n=7616) had a history of migraine. Rates of hypertension, hyperlipidemia, and obesity were comparable in participants with and without migraine.
During 22 years of follow-up, there were 211 incident strokes in participants with migraine compared with 1943 in patients without migraine (hazard ratio [HR], 1.03; 95% CI, 0.89-1.19; P =.679). Participants with migraine had 187 myocardial infarction incidents during the follow-up period compared with 1723 in participants without migraine (HR, 0.99; 95% CI, 0.85-1.16; P =.926.
In total, there were 617 incident composite CVD events in participants with migraine compared with 5672 in participants without migraine (HR, 0.99; 95% CI, 0.91-1.08; P =.793). The researchers did not find any interaction with age (ie, ≥60 vs <60 years) or migraine history with regard to CVD outcomes.
“As migraine is highly prevalent in the population, these findings have significant public health implications,” noted the researchers.
Pavlovic J, Yang J, Hedlin H, et al. The relationship between migraine and risk of cardiovascular disease in postmenopausal women in the observational longitudinal cohort of the women’s health initiative study (WHI). Abstract presented at: 61st Annual Scientific Meeting of the American Headache Society; July 11-14, 2019; Philadelphia, Pennsylvania.