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July 09, 2020
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Women with migraine aura have higher CVD rates

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Women who developed migraine with aura had a higher incidence rate of CVD vs. women who developed migraine without aura or had no migraine, according to a cohort study published in JAMA.

“The contribution of migraine with aura in direct relation to the contribution of other major vascular risk factors has, to the best of my knowledge, never been shown before,” Tobias Kurth, MD, ScD, professor at the Institute of Public Health at the Charité – Universitätsmedizin in Berlin, told Healio Primary Care.

Adjusted incidence rate of major CVD per 1,000 person-years: First bar: 3.36 / Text below first bar: In women with migraine with aura / Second bar: 2.11 Text below second bar: In women with migraine without aura or no migraine
Reference: Kurth T, et al. JAMA. 2020;doi:10.1001/jama.2020.7172.

Researchers reviewed lipid measurement data from 27,858 women (mean age, 54.7 years; migraine with aura, 1,435) in the Women’s Health Study cohort who had no CVD at baseline. Among these women, there were 1,666 major CVD events during a mean follow-up of 22.6 years.

Tobias Kurth
Tobias Kurth

Kurth and colleagues reported that the adjusted incidence rate of major CVD per 1,000 person-years was 3.36 (95% CI, 2.72-3.99) for women with migraine with aura compared with 2.11 (95% CI, 1.98-2.24) for women with migraine without aura or no migraine. The incidence rate for women with migraine with aura was significantly higher than the adjusted incidence rate among women with obesity (2.29; 95% CI, 2.02-2.56), low HDL cholesterol (2.63; 95% CI, 2.33-2.94) or high triglycerides (2.67; 95% CI, 2.38-2.95). However, these rates were not significantly different among women with family history of myocardial infarction (2.71; 95% CI, 2.38-3.05), high total cholesterol (2.85; 95% CI, 2.38-3.32) or elevated systolic BP (3.78; 95% CI, 2.76-4.81).

Researchers noted that incidence rates of CVD among women who currently smoked (4.29; 95% CI, 3.79-4.79) or had diabetes (5.76; 95% CI, 4.68-6.84) were significantly higher than those with migraine with aura. The incremental increase in the incidence rate of CVD among women who developed migraine with aura ranged from 1.01 additional cases per 1,000 person-years when added to obesity to 2.57 additional cases per 1,000 person-years when added to diabetes.

“Information on migraine with aura should be considered in the cardiovascular risk assessment, at least in women,” Kurth said. “Particular care, such as prevention of CVD, should be considered.”