title: Migraine and risk of stroke in older adults: Northern Manhattan Study.
abstract: OBJECTIVE
  To examine the association between migraine and stroke/vascular outcomes in a racially/ethnically diverse, older cohort.
  
  
  METHODS
  Participants from the Northern Manhattan Study, a population-based cohort study of stroke incidence, were assessed for migraine symptoms using a self-report questionnaire based on criteria from the International Classification of Headache Disorders, second edition. We estimated the association between migraine and combined vascular events including stroke and stroke only over a mean follow-up of 11 years, using Cox models adjusted for sociodemographic and vascular risk factors.
  
  
  RESULTS
  Of 1,292 participants (mean age 68 ± 9 years) with migraine data followed prospectively for vascular events, 262 patients (20%) had migraine and 75 (6%) had migraine with aura. No association was found between migraine (with or without aura) and risk of either stroke or combined cardiovascular events. There was an interaction between migraine and current smoking (p = 0.02 in relation to stroke and p = 0.03 for combined vascular events), such that those with migraine and smoking were at an increased risk. The hazard ratio of stroke for migraine among current smokers was 3.17 (95% confidence interval [CI] 1.13-8.85) and among current nonsmokers was 0.77 (95% CI 0.44-1.35). In relation to combined vascular events, the hazard ratio for migraine vs no migraine among current smokers was 1.83 (95% CI 0.89-3.75) and among current nonsmokers was 0.63 (95% CI 0.43-0.94).
  
  
  CONCLUSIONS
  In our racially/ethnically diverse population-based cohort, migraine was associated with an increased risk of stroke among active smokers but not among nonsmokers.
authors.affiliation: From the Department of Neurology (T.S.M., H.G., T.R., R.L.S.), University of Miami School of Medicine, FL; and Department of Neurology (M.S.V.E.), College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. tmonteith@miami.edu.
authors.forename: Teshamae S
authors.initials: TS
authors.lastname: Monteith
authors.affiliation: From the Department of Neurology (T.S.M., H.G., T.R., R.L.S.), University of Miami School of Medicine, FL; and Department of Neurology (M.S.V.E.), College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Hannah
authors.initials: H
authors.lastname: Gardener
authors.affiliation: From the Department of Neurology (T.S.M., H.G., T.R., R.L.S.), University of Miami School of Medicine, FL; and Department of Neurology (M.S.V.E.), College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.affiliation: From the Department of Neurology (T.S.M., H.G., T.R., R.L.S.), University of Miami School of Medicine, FL; and Department of Neurology (M.S.V.E.), College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.affiliation: From the Department of Neurology (T.S.M., H.G., T.R., R.L.S.), University of Miami School of Medicine, FL; and Department of Neurology (M.S.V.E.), College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology*; D020325:Migraine with Aura / Q000453:epidemiology; D009518:New York; D016016:Proportional Hazards Models; D012306:Risk; D012907:Smoking / Q000009:adverse effects*; D020521:Stroke / Q000453:epidemiology*