The American journal of medicine 2017 01 18() pii S0002-9343(17)30031-1
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 which 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 non-fatal 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, non-fatal myocardial infarction, heart failure or stroke) (HR 1.83 CI 1.22-2.75) at a median follow up of 6.5 years. This result was driven mainly by a two-fold increase in the risk of stroke (HR 2.33 CI 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 two-fold increase in the risk of stroke.