Men who have migraine headaches may be at increased risk for major cardiovascular disease events including myocardial infarction

Men who have migraine headaches may be at increased risk for major cardiovascular disease events, especially myocardial infarction, according to an article in the April 23 issue of Archives of Internal Medicine.

More than 28 million people in the United States have migraine headaches, a condition that peaks in midlife, according to background information in the article. Approximately 18 percent of women and 6 percent of men have migraines.

Tobias Kurth, MD, ScD, Harvard Medical School, Harvard School of Public Health and Brigham and Women’s Hospital, Boston, and colleagues studied 20,084 men age 40 to 84 years without a previous history of heart disease in the US Physicians Health Study.

From time of enrollment (between 1981 and 1984) through 2005, participants were sent yearly questionnaires asking about cardiovascular disease events including non-fatal ischemic stroke, non-fatal myocardial infarction, or death from ischemic cardiovascular disease. Coronary revascularization and angina were also evaluated.
Participants were classified as having migraine if they indicated they had one or more migraine headaches during the first five years of follow-up. A total of 1,449 (7.2 percent) of men reported migraines, including 434 men with frequent migraines (four or more episodes during the five-year period).

During an average of 15.7 years of follow-up, 2,236 major ischemic cardiovascular disease events occurred, including 750 ischemic strokes, 1,046 myocardial infarctions and 866 ischemic cardiovascular disease deaths, plus 2,257 coronary revascularizations and 2,625 cases of angina.

“Compared with men who did not report migraine, those who reported migraine were at significantly increased risk of major cardiovascular disease and myocardial infarction,” the authors wrote.

The incidence of major cardiovascular disease per 10,000 men per year was 8.5 for men without migraine and 10.4 for men with migraine.

“Several mechanisms have been proposed supporting a biological link between migraine and vascular events,” the authors wrote. For instance, men with an increased body mass index tend to have more frequent and severe migraines as well as an increased risk of heart disease, and it is possible that migraines are a marker for atherosclerosis, or a buildup of plaque in the arteries. “However, the increased risk of vascular events remained after controlling for major cardiovascular risk factors in the present data and other studies.”

“In conclusion, in this large prospective cohort of apparently healthy middle-aged men, migraine was associated with increased risk of subsequent major cardiovascular disease, which was driven by increased risk of myocardial infarction,” the authors wrote.


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