title: Migraine Headache and Long-Term Cardiovascular Outcomes: An Extended Follow-Up of the Women's Ischemia Syndrome Evaluation.
abstract: The association between migraine headache and cardiovascular events has been inconsistent. This study determines the long-term risk of cardiovascular events among women with and without a history of migraine headache who were under evaluation for suspected myocardial ischemia in the Women's Ischemia Syndrome Evaluation (WISE).
  
  
  
  The WISE is a National Heart, Lung and Blood Institute-sponsored prospective, multicenter study that aims to improve myocardial ischemia evaluation in women. A total of 936 women presenting with symptoms of myocardial ischemia underwent structured data collection and coronary angiography. Information pertaining to migraine headache was available in 917 women. All-cause mortality data were available on all women for a median of 9.5 years, and nonfatal cardiovascular event data were available on 888 women for a median of 6.5 years.
  
  
  
  A total of 224 (24.4%) women reported a history of migraine headache. Compared with women who did not report a history of migraine headache, women with a history of migraine headache had an increased adjusted risk of cardiovascular event (cardiovascular death, nonfatal myocardial infarction, heart failure, or stroke) (hazard ratio 1.83; 95% confidence interval, 1.22-2.75) at a median follow-up of 6.5 years. This result was driven mainly by a twofold increase in the risk of stroke (hazard ratio 2.33; 95% confidence interval, 1.16-4.68).
  
  
  
  Among women being evaluated for ischemic heart disease, those reporting a history of migraine headache had increased risk of future cardiovascular events on long-term follow-up. This risk was primarily driven by a more-than twofold increase in the risk of stroke.
authors.affiliation: Department of Medicine, University of Florida, Gainesville. Electronic address: cecil.rambarat@medicine.ufl.edu.
authors.forename: Cecil A
authors.initials: CA
authors.lastname: Rambarat
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Florida, Gainesville.
authors.forename: Islam Y
authors.initials: IY
authors.lastname: Elgendy
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
authors.forename: B Delia
authors.initials: BD
authors.lastname: Johnson
authors.affiliation: Department of Medicine, University of Pittsburgh, Pa.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Reis
authors.affiliation: Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pa.
authors.forename: Diane V
authors.initials: DV
authors.lastname: Thompson
authors.affiliation: Rhode Island Hospital, Providence.
authors.forename: Barry L
authors.initials: BL
authors.lastname: Sharaf
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham.
authors.forename: Vera
authors.initials: V
authors.lastname: Bittner
authors.affiliation: Division of Heart and Vascular Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Md.
authors.forename: George
authors.initials: G
authors.lastname: Sopko
authors.affiliation: Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, Calif.
authors.forename: C Noel
authors.initials: CN
authors.lastname: Bairey Merz
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, University of Florida, Gainesville.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Pepine
authors.affiliation: Division of Cardiovascular Disease, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
authors.forename: Bina
authors.initials: B
authors.lastname: Ahmed
mesh_terms: D002318:Cardiovascular Diseases / Q000150:complications* / Q000401:mortality; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications*; D017202:Myocardial Ischemia / Q000150:complications; D011446:Prospective Studies; D012307:Risk Factors
keywords: Cardiovascular disease; Migraine; Mortality; Stroke; Women