Migraine with aura ‘doubles risk for ischemic stroke’
MedWire News: Migraine with aura is associated with a two-fold increased risk for ischemic stroke, shows US research published in the British Medical Journal.
The risk was further increased in the presence of female gender, smoking, young age, and use of oral contraceptives, report Markus Schürks (Harvard Medical School, Boston, Massachusetts) and fellow investigators.
The study was a systematic review and meta-analysis of published research that aimed to clarify the associations among migraine and vascular disease. Schürks’s team identified and extracted data from nine case–control and cohort studies before calculating pooled relative risks (RRs).
The RRs were 1.73 for any type of migraine and ischemic stroke and 2.16 for migraine with aura and ischemic stroke, but only the latter finding was statistically significant.
The risk for stroke was also increased in certain subsets of migraine sufferers, namely women (RR=2.08), smokers (RR=9.03), those under 45 years of age (RR=2.65), and women currently using oral contraceptives (RR=7.02).
The group at greatest risk for stroke was female migraineurs with aura who were current smokers and users of oral contraceptives, in whom the pooled RR was 10.0.
There was no overall association between migraine and myocardial infarction or death due to cardiovascular disease, however.
Based on their findings, Schürks’s team suggests that young women who suffer from migraine with aura should be advised not to smoke or use estrogen-containing oral contraceptives.
“Additional research is needed to delineate in more details the association between migraine and cardiovascular disease,” they write.
“Finally, markers of migraine severity, including frequency of attacks and frequency of aura, should be considered in the association between migraine and cardiovascular disease.”
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By Joanna Lyford