Migraines Tied to Higher Heart Trouble Risk

Dennis Thompson wrote . . . . . . . .

Migraine sufferers might have to worry about more than just dealing with debilitating headaches.

Migraine patients could also face an increased risk of heart attacks, strokes, blood clots and irregular heart rates, a new study suggests.

The risk to heart health appears to be strongest in the first year after diagnosis of migraine, but persists for as long as two decades, said lead researcher Dr. Kasper Adelborg. He is a postdoctoral fellow of clinical epidemiology at the Aarhus University Hospital in Denmark.

“Accumulating evidence supports that migraine should be considered as an important risk factor for most cardiovascular diseases in both men and women,” Adelborg said.

Migraine affects about 15 percent of people, mainly women, and was the second leading cause of years lost to disability in 2016, according to background information provided by the researchers.

For the study, Adelborg and his colleagues gathered records from patients treated at Danish hospitals and hospital outpatient clinics between 1995 and 2013. The investigators wound up with just over 51,000 migraine patients and slightly more than 510,300 non-migraine patients matched for comparison.

The findings showed that migraine patients more frequently suffered a host of heart- and blood vessel-related health problems, though a cause-and-effect relationship wasn’t proven.

According to the researchers, for every 1,000 people:

  • 25 migraine patients had a heart attack, compared with 17 migraine-free people.
  • 45 migraine sufferers had a blood clot-related stroke versus 25 without the headache disorder.
  • 27 migraine patients developed life-threatening blood clots in their veins, compared with 18 people without migraines.
  • 47 people with migraine developed an irregular heartbeat, versus 34 migraine-free people.

Migraine remained linked to these heart problems even after researchers took into account other risk factors, such as excess weight or smoking.

The findings were published online in the BMJ.

In an editorial that accompanied the study, Dr. Tobias Kurth, an adjunct professor of epidemiology with the Harvard T.H. Chan School of Public Health, and colleagues wrote: “We now have plenty of evidence that migraine should be taken seriously as a strong cardiovascular risk marker.”

Despite these observations, the absolute risk for all heart-related health problems remained low. That was expected, the researchers noted, given that the patients evaluated in this study were relatively young, with an average age of 35.

That means that an individual’s risk of heart attack or stroke won’t necessarily increase drastically if they suffer migraines.

However, Adelborg said, in the broad scheme of things, the increased risk from migraines must be taken seriously.

“Although the absolute risks of cardiovascular diseases were low at the individual level, it translates into a substantial increase in risk at the population level, because migraine is a very common disease,” he explained.

The researchers cannot say with certainty why migraines might pose a potential threat to heart health, but they have some theories.

For example, cerebral arteries sometimes suddenly constrict during a migraine, which could increase stroke risk, Adelborg said. People suffering from a migraine also often lie down for long periods of time, which can make blood clots more likely.

Mayo Clinic cardiologist Dr. Gerald Fletcher suspects migraines and heart problems both have at least one serious risk factor in common.

“I think probably the common thing is high blood pressure,” Fletcher said. “It is related in that respect.”

Migraine patients who want to reduce their stroke risk should consider taking steps to lower their blood pressure, including exercising regularly and eating a healthy diet, Fletcher suggested.

Doctors could also consider revising migraine treatment guidelines, which now do not recommend use of aspirin or other blood-thinning drugs to help prevent migraines, Adelborg added.

“Future studies should address whether [migraine] patients at particularly high risk of cardiovascular diseases would benefit from anticoagulant treatment,” Adelborg said.

Source: HealthDay


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A Healthier Weight May Mean Fewer Migraines

Kathleen Doheny wrote . . . . . .

Your weight just might influence your risk of migraine headaches, a new review finds.

“Those with migraine and [their] doctors need to be aware that excessive weight and extreme weight loss are not good for [migraine sufferers], and that maintaining a healthy weight can decrease the risk of migraine,” said study corresponding author Dr. B. Lee Peterlin.

She is director of headache research at Johns Hopkins University School of Medicine in Baltimore.

“Healthy lifestyle choices in terms of weight management and diet and exercise are warranted,” she added.

Migraines affect about 12 percent of U.S. adults, according to background information from Johns Hopkins. These debilitating headaches are often accompanied by throbbing, nausea and sensitivity to light and sounds.

Peterlin’s team evaluated 12 previously published studies with nearly 300,000 people, a process known as a meta-analysis.

The investigators found that obese people were 27 percent more likely to have migraines than people who were at a normal weight.

And those who were underweight were 13 percent more likely to have migraines.

The researchers used the standard definitions of both obesity — a body mass index (BMI) of 30 or higher — and underweight, a BMI of less than 18.5. A person who is 5 feet 4 inches tall and weighs 175 pounds has a BMI of 30, while someone of the same height who weighs 105 has a BMI of 18.

In previous research, Peterlin’s team found that the link between obesity and migraines was greater for women and for those under the age of 55. This new study reaffirmed those findings.

The new review found that the link between obesity and migraines is a moderate one, Peterlin said. It’s similar to the link between migraines and ischemic heart disease, in which the heart doesn’t get enough blood, she added.

Peterlin said she can’t explain with certainty how body composition affects migraine risk. But, she speculated that fat tissue “is an endocrine organ and like other endocrine organs, such as the thyroid, too much and too little cause problems.”

The change in fat tissue that occurs with weight gain or extreme weight loss alters the function and production of several proteins and hormones, Peterlin explained, changing the inflammatory environment in the body. This could make a person more prone to a migraine or it could trigger a migraine, she said.

However, the study only found an association, and not a cause-and-effect relationship, between weight and migraine risk.

The review was published in the journal Neurology.

Would weight loss or gain help? It’s not certain, Peterlin said.

“Limited data in humans show that in both episodic and chronic [migraine sufferers] who are extremely obese and undergo bariatric surgery for other health reasons also have a reduction in headache frequency by over 50 percent,” she said. Aerobic exercise has also been shown to decrease headaches.

“What is not yet clear is if it is the weight loss per se or other factors related to exercise that result in the improvement,” Peterlin said.

One headache specialist who wasn’t involved with the study lauded the findings.

The new analysis is “a valuable addition to the growing body of literature on migraine and body mass index,” said Dawn Buse, director of behavioral medicine at the Montefiore Headache Center in New York City.

With her patients, Buse said, she has seen migraine frequency increase with weight gain. And she has also seen improvement in migraines after weight loss, she said.

Buse acknowledged that, while weight loss appears to help, losing weight can be challenging. Health care professionals should discuss with their patients the relationship with migraines, and help them by providing education and referrals for treatments that may help weight loss.

Source: HealthDay


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Women with Migraines Have Higher Risk of Cardiovascular Disease and Mortality

Women diagnosed with migraines have a slightly increased risk of developing cardiovascular diseases, such as heart attacks and strokes, and are somewhat more likely to die from these conditions than women who do not have migraine, according to findings of a large study published in The BMJ today.

These results add to evidence that migraine should be considered an important risk marker for cardiovascular disease, say experts. But more research is needed to determine possible causes, and whether treatments to prevent migraines could help to reduce these associated risks.

Migraine has been consistently linked with an increased risk of stroke, but few studies have shown an association of migraine with cardiovascular diseases and mortality.

So a team of US and German researchers carried out a large prospective study to evaluate associations between migraine, cardiovascular disease and mortality.

They analysed data from 115,541 women enrolled in the Nurses’ Health Study II. The participants were aged 25-42 years, free from angina and cardiovascular disease, and followed from 1989-2011 for cardiovascular events, diseases and mortality.

Overall, 17,531 (15.2%) women reported a physician’s diagnosis of migraine at baseline. Over 20 years of follow-up, 1,329 total cardiovascular disease events occurred and 223 women died due to cardiovascular disease.

When compared to women who did not have migraine, these results show that women who reported a migraine had a greater risk for major cardiovascular disease, including heart attacks, strokes and angina/coronary revascularization procedures.

These associations remained after adjusting for other factors that may have increased the risk for these diseases.

In addition, migraine was associated with a higher risk for cardiovascular mortality. This association was similar across subgroups of women, including by age, smoking status, hypertension, postmenopausal hormone therapy, and oral contraceptive use.

In a linked editorial, Rebecca Burch from Harvard Medical School and Melissa Rayhill from The State University of New York at Buffalo caution that “the magnitude of the risk should not be over-emphasized,” as “it is small at the level of the individual patient, but still important at a population level because migraine is so prevalent.”

While the current study controlled for a large number of vascular risk factors, no information was available for vascular biomarkers, and migraine specifics, such as migraine aura.

Nevertheless, the authors say “these results further add to the evidence that migraine should be considered an important risk marker for cardiovascular disease, at least in women,” and there is no reason why the findings can’t be applicable to men.

“Given the high prevalence of migraine in the general population, an urgent need exists to understand the biological processes involved and to provide preventive solutions for patients,” they conclude.

The editorialists Rebecca Burch and Melissa Rayhill agree “it’s time to add migraine to the list of early life medical conditions that are markers for later life cardiovascular risk.”

They say this latest study raises questions about whether treatments that decrease the frequency or severity of migraine may reduce later life vascular risks, and conclude by saying “what little evidence we do have suggests the need for therapeutic restraint [to prevent cardiovascular risk] until we have a better understanding of the mechanisms underlying the link between migraine and vascular disease.”

Source: EurekAlert!


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Older Migraine Sufferers May Have More Silent Brain Injury

Ischemic silent brain infarctions are symptomless brain injuries and are a risk factor for future strokes.

Older migraine sufferers may be more likely to have silent brain injury, according to research published in the American Heart Association’s journal Stroke.

In a new study, people with a history of migraine headaches had double the odds of ischemic silent brain infarction compared to people who said they didn’t have migraines. Silent brain infarction is a brain injury likely caused by a blood clot interrupting blood flow to brain tissue. Sometimes called “silent strokes,” these injuries are symptomless and are a risk factor for future strokes.

Previous studies indicated migraine could be an important stroke risk factor for younger people.

“I do not believe migraine sufferers should worry, as the risk of ischemic stroke in people with migraine is considered small,” said Teshamae Monteith, M.D., lead author of the study and assistant professor of clinical neurology and chief of the Headache Division at the University of Miami Miller School of Medicine. “However, those with migraine and vascular risk factors may want to pay even greater attention to lifestyle changes that can reduce stroke risk, such as exercising and eating a low-fat diet with plenty of fruits and vegetables.”

High blood pressure, another important stroke risk factor, was more common in those with migraine. But the association between migraine and silent brain infarction was also found in participants with normal blood pressure.

Because Hispanics and African-Americans are at increased stroke risk, researchers from the Northern Manhattan Study (NOMAS) – a collaborative investigation between the University of Miami and Columbia University – studied a multi-ethnic group of older adults (41 percent men, average age 71) in New York City. About 65 percent of participants were Hispanic. Comparing magnetic resonance imaging results between 104 people with a history of migraine and 442 without, they found:

  • A doubling of silent brain infarctions in those with migraine even after adjusting for other stroke risk factors;
  • No increase in the volume of white-matter hyperintensities (small blood vessel abnormalities) that have been associated with migraine in other studies;
  • Migraines with aura — changes in vision or other senses preceding the headache — wasn’t common in participants and wasn’t necessary for the association with silent cerebral infarctions.

“While the lesions appeared to be ischemic, based on their radiographic description, further research is needed to confirm our findings,” Monteith said.

The research raises the question of whether preventive treatment to reduce the severity and number of migraines could reduce the risk of stroke or silent cerebral infarction.

“We still don’t know if treatment for migraines will have an impact on stroke risk reduction, but it may be a good idea to seek treatment from a migraine specialist if your headaches are out of control,” Monteith said.

Source: American Heart Association


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Migraines Hurt Your Head But Not Your Brain

Migraines currently affect about 20 percent of the female population, and while these headaches are common, there are many unanswered questions surrounding this complex disease. Previous studies have linked this disorder to an increased risk of stroke and structural brain lesions, but it has remained unclear whether migraines had other negative consequences such as dementia or cognitive decline. According to new research from Brigham and Women’s Hospital (BWH), migraines are not associated with cognitive decline.

This study is published online by the British Medical Journal (BMJ). “Previous studies on migraines and cognitive decline were small and unable to identify a link between the two. Our study was large enough to draw the conclusion that migraines, while painful, are not strongly linked to cognitive decline,” explained Pamela Rist ScD, a research fellow in the Division of Preventive Medicine at BWH, and lead author on this study.

The research team analyzed data from the Women’s Health Study, a cohort of nearly 40,000 women, 45 years and older. In this study, researchers analyzed data from 6,349 women who provided information about migraine status at baseline and then participated in cognitive testing during follow-up. Participants were classified into four groups: no history of migraine, migraine with aura (transient neurology symptoms mostly of the visual field), migraine without aura, and past history of migraine. Cognitive testing was carried out in two year intervals up to three times.

“Compared with women with no history of migraine, those who experienced migraine with or without aura did not have significantly different rates of cognitive decline,” explained Rist. “This is an important finding for both physicians and patients. Patients with migraine and their treating doctors should be reassured that migraine may not have long term consequences on cognitive function.”

There is still a lot that is unknown about migraines. However this study offers promising evidence for patients and their treating physicians. More research needs to be done to understand the consequences of migraine on the brain and to establish strategies to influence the course of the disease in order to optimize treatment strategies.

Source: Brigham and Women’s Hospital