Migraine with and without aura and risk for cardiovascular disease.
Migraine, cardiovascular disease, and stroke are three highly prevalent and disabling conditions that exert a significant socioeconomic impact. The association between migraine and a twofold risk of stroke and myocardial infarction has been the topic of much debate. The mechanism underlying this link is largely unknown but may be the result of an increased prevalence of other conditions such as vasculopathies, hypercoagulable states, and patent foramen ovale seen in migraine with aura. Although many prior studies have demonstrated increased risks in women with migraine with aura, an emerging body of evidence is showing similar risks in men. These risks are further compounded with increased migraine frequency, smoking, and the use of oral contraceptive pills. Because the overall risk for stroke and myocardial infarction in migraineurs remains relatively low, recommendations at this time are limited to the modification of cardiovascular risk factors, such as smoking cessation and the avoidance of oral contraceptive pills, especially in women suffering from migraine with aura.
Vargas
Bert B
BB
Department of Neurology, Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA. bvargas@neurotucson.com
Dodick
David W
DW
Wingerchuk
Dean M
DM
Demaerschalk
Bart M
BM
D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003276:Contraceptives, Oral / Q000009:adverse effects; D004730:Endothelium, Vascular / Q000503:physiopathology; D054092:Foramen Ovale, Patent / Q000453:epidemiology; D006801:Humans; D020325:Migraine with Aura / Q000453:epidemiology*; D020326:Migraine without Aura / Q000453:epidemiology*; D009203:Myocardial Infarction / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology
D003276:Contraceptives, Oral