Headache, cerebrovascular symptoms, and stroke: the Atherosclerosis Risk in Communities Study.
OBJECTIVE
To evaluate the occurrence of stroke/TIA symptoms and ischemic stroke events among those with a lifetime history of migraine or other headaches with some migraine features in a biracial cohort of older adults.


METHODS
Participants were 12,750 African-American and white men and women from the Atherosclerosis Risk in Communities Study (1993 to 1995). The participants were queried about their lifetime headache history and characterized using modified International Headache Society diagnostic criteria. Stroke/TIA symptoms were classified using a computerized diagnostic algorithm, and ischemic stroke events were identified and validated using medical records. Multivariate logistic regression was used to assess the relationship between headache types and stroke/TIA symptoms and ischemic stroke events.


RESULTS
Migraine with aura was strongly associated with stroke symptoms (odds ratio [OR] 5.46, 95% CI: 3.64 to 8.18), TIA symptoms (OR 4.28, 95% CI: 3.02 to 6.08), and verified ischemic stroke events (OR 2.81, 95% CI: 1.60 to 4.92). Similarly, other headaches with aura were significantly associated with stroke symptoms (OR 3.68, 95% CI: 2.26 to 5.99) and TIA symptoms (OR 4.53, 95% CI: 3.08 to 6.67). In contrast, the associations for migraine without aura and other headaches without aura were not as consistent or robust.


CONCLUSIONS
Migraines and other headaches, particularly those accompanied by aura, were associated with an increased occurrence of stroke/TIA symptoms and ischemic stroke events.
Stang
P E
PE
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
Carson
A P
AP
Rose
K M
KM
Mo
J
J
Ephross
S A
SA
Shahar
E
E
Szklo
M
M
D000367:Age Factors; D000465:Algorithms; D044383:Black People; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003625:Data Collection; D003937:Diagnosis, Differential; D005260:Female; D006306:Health Surveys; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D044465:White People; D001741:Black or African American