title: Practical implications of the migraine cardio- and cerebrovascular association: unmet needs of patients.
abstract: BACKGROUND
  Numerous studies have described a relationship between migraine and stroke, and there is emerging evidence that migraine is also associated with cardiovascular disease. The combination of migraine and both cerebrovascular and cardiovascular disease has implications for therapy.
  
  
  METHODS
  We conducted a review of the modifications in medical therapy in patients with comorbid migraine and cardio- and cerebrovascular disorders based on publications from the last 15 years.
  
  
  RESULTS
  Some drugs are contraindicated to treat migraine attacks (ergots, triptans) or for migraine prevention in patients after transient ischemic attack (TIA)/ischemic stroke. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in patients with cerebral bleeding. Some drugs for the treatment of acute migraine attacks are contraindicated in patients with symptomatic coronary heart disease.
  
  
  CONCLUSIONS
  Given the large number of patients with comorbid migraine and cardiovascular as well as cerebrovascular disease, there is an unmet need to treat these patients.
authors.affiliation: Department of Neurology and Headache Center, University Hospital Essen, Germany hans.diener@uni-duisburg-essen.de.
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Diener
authors.affiliation: Inserm Research Center for Epidemiology and Biostatistics (U897)-Team Neuroepidemiology, Bordeaux, France University of Bordeaux, College of Health Sciences, Bordeaux, France.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kurth
authors.affiliation: Department of Neurology and Headache Center, University Hospital Essen, Germany.
authors.forename: Dagny
authors.initials: D
authors.lastname: Holle
mesh_terms: D002318:Cardiovascular Diseases / Q000150:complications* / Q000188:drug therapy; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000188:drug therapy; D015897:Comorbidity; D006301:Health Services Needs and Demand; D006801:Humans; D008881:Migraine Disorders / Q000150:complications* / Q000188:drug therapy
keywords: Migraine; TIA; cardiovascular; cerebral hemorrhage; medical therapy; stroke