Migraine and subclinical atherosclerosis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
BACKGROUND
The relationship between migraine and coronary heart disease (CHD) remains controversial. We aimed to investigate the association of subclinical atherosclerosis and migraine with or without aura compared to a non-migraine subgroup (reference) in a large Brazilian multicentric cohort study, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).


METHODS
Migraine diagnostic was based on International Headache Society criteria, and aura symptoms were validated by a medical doctor in a sub-sample of the ELSA-Brasil, who also underwent coronary artery calcium score (CAC) and carotid intima-media thickness (C-IMT) evaluations. Subclinical atherosclerosis indexes (CAC and C-IMT) were analyzed as dependent variables and migraine (all, with aura, without aura) as an independent variable in the linear and multinomial logistic regression models adjusted for possible confounders.


RESULTS
Of 3217 ELSA participants free from CVD at baseline, we found a migraine frequency of 11.9% (5.1% with aura and 6.8% without aura). Overall, migraineurs were mostly women, younger and had lower frequency of CV risk factors, such as hypertension, diabetes and low HDL-cholesterol, compared to non-migraineurs. The strongest inverse correlation between migraine and subclinical atherosclerosis was verified with CAC score. However, all associations lost their significance after multivariate adjustment.


CONCLUSIONS
In this cross-sectional evaluation of the ELSA study, migraine was not associated with subclinical atherosclerosis, regardless of aura symptoms.
Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil agoulart@hu.usp.br.
Alessandra C
AC
Goulart
Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil School of Medicine, University of São Paulo, Brazil.
Itamar S
IS
Santos
Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.
Márcio S
MS
Bittencourt
Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil School of Medicine, University of São Paulo, Brazil.
Paulo A
PA
Lotufo
Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil School of Medicine, University of São Paulo, Brazil.
Isabela M
IM
Benseñor
D000328:Adult; D001938:Brazil; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology*
Migraine with aura; observational study; subclinical atherosclerosis