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The risk is higher still for young women with migraine and visual aura who also smoke and are on the Pill, Dr Steven Kittner and his associates report in the American Heart Association's journal Stroke.
The link between migraine and stroke in young women is well established, they note, but details are sketchy. This prompted Kittner, a neurologist at the VA Maryland Health Care System in Baltimore, and his team to evaluate data from the Stroke Prevention in Young Women Study.
The study involved 386 women between the ages of 15 and 49 years who were hospitalised with a stroke and 614 ‘control’ women, matched by age and race. Based on their headache history, subjects were classified as having probable migraine with visual aura, probable migraine without aura, or no migraine.
Women who smoke at higher risk
Women with probable migraine with visual aura had 1.5-fold greater odds of having a stroke compared with women with no migraine. The risk was not associated with migraine without aura.
After factoring in age, race, and geographic region, "women with probable migraine with visual aura who smoked and used oral contraceptives had 6.9-fold higher odds of stroke compared with women with probable migraine with visual aura who were non-smokers and non-oral contraceptive users," Kittner and his associates report.
In a similar analysis, women with probable migraine with visual aura who smoked and used oral contraceptives had a 10-fold higher risk than women with no migraine history who never smoked or used oral contraceptives.
In a statement from the American Heart Association, Kittner points out that "young women with probable migraine with visual symptoms can reduce their risk of stroke by stopping smoking and finding alternatives to the use of oestrogen-containing contraceptives." - (ReutersHealth, August 2007)
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