Connection Between Migraine and Hypertension in Women
Pamela Rist, ScD, of Harvard Medical School, discusses her research on hypertension in women with migraine, and how the findings may impact not only neurologists, but primary care providers.
Hi. My name is Pamela Rist, and I am an associate epidemiologist at Brigham and Women's Hospital and also at Harvard Medical School. My abstract was on migraine and the risk of incident hypertension among women.
We have known for a few years that migraine seems to be associated with an increased risk of vascular disorders, particularly stroke and even myocardial infarction. The question was, “Is it associated with a disorder like hypertension, as well?” The evidence on this is actually pretty mixed, and most studies were not able to tease out what happened first: did migraine precede hypertension, or did hypertension precede the migraine? Using a prospective, longitudinal design, we assessed whether migraineurs have an increased risk of developing hypertension in the future compared with people who do not have migraine.
To do this, our study – the Women's Health Study – was a cohort study of female health professionals aged 45 or older at baseline, and we now have an average of 12 years of follow-up for our hypertension outcome. What we found by looking at the study was that women who experience migraine do appear to be at an increased risk of hypertension – it is anywhere from a 10% to 20% risk, depending on their specific migraine type – compared to women who do not have any history of migraine.
Most of the prior research on migraine and the risk of stroke had controlled for variables like hypertension, so what they were looking at is that even if you don't have hypertension, does migraine increase the risk of stroke? Those studies have shown that yes, it does seem to increase your risk of stroke. It is a risk marker, at least.
From our study, I think the message is more for primary care physicians potentially, that migraineurs, regardless of whether they experience aura or not, do seem to be at an increased risk for hypertension. So, this is something to look for in your patients and screen them for it, and there are a variety of treatments that can be used. And that is certainly the next area – what treatment should we be using for migraineurs.