Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study.
OBJECTIVE
To estimate whether migraine in mid-life is associated with mortality from cardiovascular disease, other causes, and all causes.


METHODS
Population based cohort study.


METHODS
Reykjavik, Iceland.


METHODS
18,725 men and women, born 1907-35 and living in Reykjavik and adjacent communities.


METHODS
Mortality from cardiovascular disease, non-cardiovascular disease, and all causes. Questionnaires and clinical measures were obtained in mid-life (mean age 53, range 33-81) in the Reykjavik Study (1967-91). Headache was classified as migraine without aura, migraine with aura, or non-migraine headache. Median follow-up was 25.9 years (0.1-40.2 years), with 470,990 person years and 10,358 deaths: 4323 from cardiovascular disease and 6035 from other causes. We used Cox regression to estimate risk of death in those with migraine compared with others, after adjusting for baseline risk factors.


RESULTS
People with migraine with aura were at increased risk of all cause mortality (adjusted (for sex and multivariables) hazard ratio 1.21, 95% confidence interval 1.12 to 1.30) and mortality from cardiovascular disease (1.27, 1.13 to 1.43) compared with people with no headache, while those with migraine without aura and non-migraine headache were not. Further examination of mortality from cardiovascular disease shows that people with migraine with aura were at increased risk of mortality from coronary heart disease (1.28, 1.11 to 1.49) and stroke (1.40, 1.10 to 1.78). Women with migraine with aura were also at increased risk of mortality from non-cardiovascular disease (1.19, 1.06 to 1.35).


CONCLUSIONS
Migraine with aura is an independent risk factor for cardiovascular and all cause mortality in men and women. The risk of mortality from coronary heart disease and stroke mortality is modestly increased in people with migraine, particularly those with aura.
Gudmundsson
Larus S
LS
Department of Pharmacology and Toxicology, University of Iceland, Hagi Hofsvallagata 53, IS-107 Reykjavik, Iceland. lsg@hi.is
Scher
Ann I
AI
Aspelund
Thor
T
Eliasson
Jon H
JH
Johannsson
Magnus
M
Thorgeirsson
Gudmundur
G
Launer
Lenore
L
Gudnason
Vilmundur
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000401:mortality*; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution