Migraine plus persistent vasomotor symptoms linked to greater stroke, CVD risks
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Key takeaways:
- Women with vs. without migraine and persistent vasomotor symptom histories had greater CVD and stroke risks.
- Both associations for CVD and stroke lessened after adjusting for CVD risk factors.
Migraine plus persistent vasomotor symptoms is associated with greater CVD risk and stroke for women, according to a secondary data analysis published in Menopause.
“Both vasomotor symptoms and migraines have each been hypothesized to represent increased vasoreactivity that could potentially predispose women to CVD events,” Catherine Kim, MD, MPH, associate professor in the departments of medicine, obstetrics and gynecology and epidemiology at the University of Michigan, Ann Arbor, and colleagues wrote. “However, it is unclear whether vasomotor symptoms and migraines are risk factors for CVD and stroke independent of traditional CVD risk factors.”
Kim and colleagues conducted a secondary analysis of data from 1,954 women from the Coronary Artery Risk Development in Young Adults (CARDIA) study, an ongoing multicenter, longitudinal, population-based cohort study. In CARDIA, researchers collected CVD risk factors every 5 years starting when participants were aged 18 to 30 years until they were aged approximately 61 years. CARDIA also obtained migraine history before and after examination at year 15 when participants were aged approximately 40 years and continued to collect this data every 5 years thereafter.
In this analysis, researchers evaluated whether migraine and vasomotor symptom trajectories at year 15 examination in CARDIA were associated with higher risk for CVD events and stroke.
Overall, 835 women had minimal, 521 had increasing and 598 had persistent vasomotor symptoms. Overall, 81 CVD events occurred, with 42 reported strokes.
After adjusting for age, race, estrogen use, oophorectomy and hysterectomy, women with migraine and history of persistent vasomotor symptom had a greater risk for CVD (HR = 2.25; 95% CI, 1.15-4.38) compared with women without such histories. When adjusted for CVD risk factors, researchers noted that associations became less strong, with an HR of 1.51 (95% CI, 0.73-3.1).
In addition, women with histories of migraine and persistent vasomotor symptoms had greater risk for stroke (HR = 3.15; 95% CI, 1.35-7.34) compared with women without such histories. However, after adjusting for CVD risk factors, associations with stroke reduced to an HR of 1.7 (95% CI, 0.66-4.38).
“Future studies are needed to examine why women with both migraines and vasomotor symptoms have the poorest CVD risk factor profiles and whether these histories can aid in risk stratification,” the researchers wrote. “Studies are also needed to examine whether this increased risk is limited to women who experience migraine with aura, and whether therapies for migraines as well as nonhormone therapies for vasomotor symptoms are associated with future CVD risk.”