Women who suffer from migraines with visual effects called aura may face an increased risk for heart attacks, strokes and blood clots, new studies find.
Only high blood pressure was a more powerful predictor of cardiovascular trouble, the researchers said.
There are things women with this type of migraine can do to reduce that risk, they added: lower blood pressure and cholesterol levels, avoid smoking, eat healthfully and exercise.
"Other studies have found that this form of migraine has been associated with the risk of stroke, and may be associated with any cardiovascular disease," said lead author Dr Tobias Kurth, from the French National Institute of Health and Medical Research in Bordeaux and Brigham and Women's Hospital in Boston. "We find migraine with aura is a quite strong contributor to major cardiovascular disease. It is one of the top two risk factors."
How the study was done
Other studies have found the risk for cardiovascular disease for people who suffer from migraines with aura is roughly double that of people without the condition, Kurth noted.
People who suffer from migraines with aura see flickering lights or other visual effects just before the headache kicks in, he explained.
The findings are to be presented in March at the American Academy of Neurology annual meeting in San Diego.
For the study, Kurth's team collected data on nearly 28 000 women who took part in the Women's Health Study. Among these women, more than 1 400 suffered from migraines with aura.
During 15 years of follow-up, more than 1 000 women had a heart attack, stroke or died from cardiovascular causes, the researchers found.
After high blood pressure, migraine with aura was the strongest predictor for having a heart attack or stroke among these women. The risk was even more pronounced than that associated with diabetes, smoking, obesity and a family history of heart disease, the investigators noted.
Whether controlling migraines reduces the risk for heart disease isn't known, Kurth said.
Aura and heart risks
The study found a link between migraines with aura and cardiovascular trouble, but it didn't prove cause-and-effect.
Although women who have migraine with aura seem to have this increased risk, it doesn't doom everyone who has migraines with aura to have a heart attack or stroke, Kurth noted.
One expert was worried by the finding.
"What is concerning about this is that migraine with aura is more of a risk than diabetes," said Dr. Noah Rosen, director of the Headache Center at Cushing Neuroscience Institute at North Shore-LIJ Health System in Manhasset, N.Y. "Maybe this will change the way we stratify risk based on a history of migraine."
Rosen doesn't think that controlling migraine will reduce the cardiovascular risks. "Migraine, in all likelihood, is a genetic phenomena, so it is not a modifiable risk factor," he said. That makes it even more important to control other risk factors for cardiovascular disease, he added.
Results of another study scheduled to be presented at the neurology meeting show that women who have migraines with aura who take hormonal contraceptives have a higher risk of blood clots than women with migraine without aura.
The study found that 7.6 percent of women with migraine with aura who used a newer generation contraceptive that combines the hormones estrogen and progestin had deep vein thrombosis (a clot in a leg vein), compared with 6.3 percent of women with migraine without aura.
This risk for clots, such as deep vein thrombosis, has been associated with all women taking hormonal contraceptives, but it is even more elevated in women with migraine, the researchers noted.
In addition, the complications from these clots is greater among women with migraine with aura. The danger of these clots is they can travel to the heart, lungs or brain and cause heart attacks, strokes or severe breathing problems.
For this study, researchers from Brigham and Women's Falkner Hospital collected data on more than 145 000 women who used hormonal contraceptives. Among these women, nearly 2 700 had migraine with aura and more than 3 400 had migraine without aura.
The reasons why migraine is linked to clotting and cardiovascular disease aren't known, Rosen said.
"Women making the decision to be on a hormonal contraceptive should discuss their headache history with their doctor," he added.
The data and conclusions of research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
For more on migraine, visit the U.S. National Library of Medicine.
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