Migraine With Aura Is Associated With Increased Risk Of Stroke

Editor's Choice
Main Category: Headache / Migraine
Also Included In: Stroke
Article Date: 29 Oct 2009 - 0:00 PDT

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A migraine with aura occurs when temporary visual or sensory disturbances are experienced before or during a migraine headache. A study just published on bmj.com reports that migraine with aura is associated with a twofold increased risk of stroke. Further risk factors for stroke among patients with migraine are being a woman, being young, being a smoker, and using contraceptives containing estrogen.

Up to 20 percent of the population is affected by migraine which is a common chronic disorder. Women are affected up to four times more often than men. Up to one third of sufferers also experience an aura prior to or during a migraine headache. The aura is often described as the perception of a strange light, an unpleasant smell or confusing thoughts or experiences.

For some time doctors have suspected a link between migraine and vascular events such as stroke. In order to further investigate, an international team of researchers analyzed the results of nine studies on the association between any migraine (with and without aura) and cardiovascular disease. To minimize bias, differences in study design and quality were considered.

Findings indicated that migraine with aura is associated with a twofold increased risk of ischemic stroke. This risk is further increased by being female, age less than 45 years, smoking, and estrogen containing contraceptive use.

No associations were found between migraine and heart attack or death due to cardiovascular disease.

In reaction to these findings, the authors suggest that young women who have migraine with aura should be strongly advised to stop smoking. In addition, methods of birth control other than estrogen containing contraceptives should be considered. Also, they suggest the need for further research in order to examine more thoroughly the association between migraine and cardiovascular disease.

In an associated editorial, Elizabeth Loder from Brigham and Women's Hospital, Boston, explains that the absolute risk of stroke for most migraine patients is low. Therefore a doubling of risk is not cause for panic. However, at a population level, this risk deserves awareness because the prevalence of migraine is so elevated.

She suggests that patients who have migraine with aura should be closely monitored and treated aggressively for modifiable cardiovascular risk factors.

"Migraine and cardiovascular disease: systematic review and meta-analysis"
Markus Schürks, instructor, Pamela M Rist, doctoral student, Marcelo E Bigal, director, Julie E Buring, professor, Richard B Lipton, professor, Tobias Kurth, senior researcher
BMJ 2009; 339:b3914
doi:10.1136/bmj.b3914

"Migraine with aura and increased risk of ischaemic stroke"
Elizabeth Loder, chief, division of headache and pain
BMJ 2009; 339:b4380
doi:10.1136/bmj.b4380
bmj.com

Written by Stephanie Brunner (B.A.)
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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