- Heart attack, stroke and irregular heartbeat can affect those with a migraine.
- People with a migraine often use anti-inflammatory drugs, which are associated with increased risks of heart problems.
- For every 1,000 patients, 45 patients with a migraine had an ischaemic stroke and 25 had a heart attack.
A migraine, the severe headache disorder can increase the chances of cardiovascular problems including heart attacks, stroke, blood clots and an irregular heart rate.
Although the risks were low, the findings suggest that "migraines should be considered a potent and persistent risk factor for most cardiovascular diseases in both men and women," say the authors.
‘For every 1,000 patients, 25 patients with a migraine had a heart attack compared with 17 migraine-free patients and 45 patients with a migraine had an ischemic stroke (blood clot in the brain) compared with 25 migraine-free patients.’
Around one billion people worldwide are affected by migraines. It has a considerable impact on quality of life and imposes a substantial burden on society.
Previous studies have suggested a link between a migraine and stroke and heart attacks, particularly among women, but the link between migraines and other heart problems are less well known.
Migraine and Risk of Heart Disease
The research team from Aarhus University Hospital, Denmark and Stanford University, USA set out to examine the risks of heart conditions including heart attacks; stroke; peripheral artery disease (narrow arteries which reduce blood flow to limbs); blood clots and fast and irregular heart rates in people who experience migraines compared with people who don't.
The research team collected patient data from the Danish National Patient Registry over a 19 year period, from 1995 to 2013.
They compared data from over 51,000 people who had been diagnosed with a migraine with over 510,000 people who were migraine-free. For each person with a migraine, they matched 10 people of the same age and gender who were migraine-free.
- The average age of migraine diagnosis was 35 years, and 71% of participants were women.
- Over a period of 19 years, migraine was positively associated with heart attack, stroke, blood clots and irregular heart rate.
- No meaningful association was found with peripheral artery disease or heart failure.
- The associations, particularly for stroke, were stronger in the first year of diagnosis than the long term
- Patients with migraine aura - warning signs of a migraine, such as seeing flashing lights show a greater risk than in those without aura, and in women than in men.
This is an observational study, so no firm conclusions can be drawn about cause and effect, and the authors cannot rule out the possibility that other unknown factors, such as physical activity, may have influenced the results. However, key strengths include the large sample size and long-term follow up.
Why Does Migraine Increase the Risk of Heart Disease?
The authors outline reasons why migraines might increase cardiovascular disease risk. For example, people with a migraine often use anti-inflammatory drugs, which are associated with increased risks of heart problems, while immobilization related to migraine attacks may increase the risk of blood clots.
They note that current guidelines do not recommend use of anti-clotting drugs such as aspirin to treat a migraine, but call on clinicians to "consider whether patients at particularly high risk of heart disease would benefit from anticoagulant treatment".
"Migraines should be considered a potent and persistent risk factor for most cardiovascular diseases," they say. "Ultimately, it will be important to determine whether prevention strategies in patients with a migraine can reduce the burden of cardiovascular disease" they conclude.
"We now have plenty of evidence that a 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.
"Unfortunately, funding for migraine research has been seriously neglected," they say, and they call on public research agencies to "act quickly by investing in prospective studies to accomplish this goal."