Headache, migraine and cardiovascular risk factors: the HUNT study.
BACKGROUND
Migraine with aura (MA) has been found to be a risk factor for cardiovascular disease including ischaemic stroke and myocardial infarction. Studies have also reported a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting as to whether this is restricted to MA or also holds true for migraine without aura (MO). This study aims to examine the relation between headache and cardiovascular risk factors in a large cross-sectional population-based study.


METHODS
A total of 48,713 subjects (age ≥ 20 years) completed a headache questionnaire and were classified according to the headache status in the Nord-Trøndelag Health Study in Norway 1995-1997 (HUNT 2). Framingham 10-year risk for myocardial infarction and coronary death could be calculated for 44,098 (90.5%) of these. Parameters measured were blood pressure, body mass index, serum total and high-density lipoprotein cholesterol.


RESULTS
Compared to controls, Framingham risk score was elevated in non-migraine headache sufferers (OR 1.17, 95% CI 1.10-1.26), migraineurs without aura (OR 1.17, 95% CI 1.04-1.32) and most pronounced amongst migraineurs with aura (OR 1.54, 95% CI 1.21-1.95). Framingham risk score consistently increased with headache frequency. For non-migrainous headache and MO, the increased risk was accounted for by the lifestyle factors smoking, high BMI and low physical activity, whilst such factors did not explain the elevated risk associated with MA.


CONCLUSIONS
Both MA, MO and non-migrainous headache are associated with an unfavourable cardiovascular risk profile, but different mechanisms seem to underlie the elevated risk in MA than in the other headache types.
Winsvold
B S
BS
Department of Neurology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway. b.k.winsvold@medisin.uio.no
Hagen
K
K
Aamodt
A H
AH
Stovner
L J
LJ
Holmen
J
J
Zwart
J-A
JA
D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000453:epidemiology*; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
D008076:Cholesterol, HDL; D002784:Cholesterol