Association between migraine and stroke in a large-scale epidemiological study of the United States.
OBJECTIVE
To examine the association between stroke and migraine in an epidemiological study. DATA SOURCES AND DESIGN: The National Health and Nutrition Examination Survey baseline and first follow-up data were used to investigate cross-sectional and longitudinal associations between headache/migraine and stroke.


METHODS
Study participants from a national probability sample of the civilian noninstitutionalized population of the United States.


METHODS
Self-reported physician diagnosis of stroke.


RESULTS
After controlling for established risk factors for stroke (hypertension, diabetes, heart disease, and gender), both migraine and severe nonspecific headache were associated with a significantly increased risk for stroke reported at follow-up. The risk for stroke associated with migraine decreased as the age at stroke increased.


CONCLUSIONS
Our results strengthen previous evidence regarding a nonrandom association of both headache and migraine with stroke, particularly among young women. To our knowledge, this is the first systematic examination in a large-scale prospective epidemiological study of men and women with sufficient statistical power to test the association between migraine and stroke in women. Severe headache and migraine should be considered as risk factors for the development of stroke, particularly in the absence of other well-established stroke risk factors. Further investigation is required to identify the putative mechanisms underlying comorbidity of migraine and stroke.
Merikangas
K R
KR
Genetic Epidemiology Research Unit, Yale University School of Medicine, New Haven, Conn, USA. Kath@zeus.psych.yale.edu
Fenton
B T
BT
Cheng
S H
SH
Stolar
M J
MJ
Risch
N
N
D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000453:epidemiology*; D012307:Risk Factors