Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 May 31:353:i2610.
doi: 10.1136/bmj.i2610.

Migraine and risk of cardiovascular disease in women: prospective cohort study

Tobias Kurth  1 , Anke C Winter  2 , A Heather Eliassen  3 , Rimma Dushkes  4 , Kenneth J Mukamal  5 , Eric B Rimm  6 , Walter C Willett  7 , JoAnn E Manson  8 , Kathryn M Rexrode  4
Affiliations

Migraine and risk of cardiovascular disease in women: prospective cohort study

Tobias Kurth et al. BMJ. .

Erratum in

Abstract

Objective: To evaluate the association between migraine and incident cardiovascular disease and cardiovascular mortality in women.

Design: Prospective cohort study among Nurses' Health Study II participants, with follow-up from 1989 and through June 2011.

Setting: Cohort of female nurses in United States.

Participants: 115 541 women aged 25-42 years at baseline and free of angina and cardiovascular disease. Cumulative follow-up rates were more than 90%.

Main outcome measures: The primary outcome of the study was major cardiovascular disease, a combined endpoint of myocardial infarction, stroke, or fatal cardiovascular disease. Secondary outcome measures included individual endpoints of myocardial infarction, stroke, angina/coronary revascularization procedures, and cardiovascular mortality.

Results: 17 531 (15.2%) women reported a physician's diagnosis of migraine. Over 20 years of follow-up, 1329 major cardiovascular disease events occurred and 223 women died from cardiovascular disease. After adjustment for potential confounding factors, migraine was associated with an increased risk for major cardiovascular disease (hazard ratio 1.50, 95% confidence interval 1.33 to 1.69), myocardial infarction (1.39, 1.18 to 1.64), stroke (1.62, 1.37 to 1.92), and angina/coronary revascularization procedures (1.73, 1.29 to 2.32), compared with women without migraine. Furthermore, migraine was associated with a significantly increased risk for cardiovascular disease mortality (hazard ratio 1.37, 1.02 to 1.83). Associations were similar across subgroups of women, including by age (<50/≥50), smoking status (current/past/never), hypertension (yes/no), postmenopausal hormone therapy (current/not current), and oral contraceptive use (current/not current).

Conclusions: Results of this large, prospective cohort study in women with more than 20 years of follow-up indicate a consistent link between migraine and cardiovascular disease events, including cardiovascular mortality. Women with migraine should be evaluated for their vascular risk. Future targeted research is warranted to identify preventive strategies to reduce the risk of future cardiovascular disease among patients with migraine.

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; TK has received investigator initiated research funding from the French National Research Agency, the US National Institutes of Health, and the University of Bordeaux and has received honorariums from the BMJ and Cephalalgia for editorial services; ACW is supported by funds from Washington University School of Medicine, the Barnes-Jewish Hospital Foundation, and Siteman Cancer Center and has received funding from the Craig H Neilsen Foundation and the National Institutes of Health; AHE, KJM, EBR, WCW, JEM, and KMR receive funding by grants from the National Institutes of Health; no other relationships or activities that could appear to have influenced the submitted work.

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Stovner Lj, Hagen K, Jensen R, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007;27:193-210. 10.1111/j.1468-2982.2007.01288.x pmid:17381554. - DOI - PubMed
    1. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013;33:629-808. 10.1177/0333102413485658 pmid:23771276. - DOI - PubMed
    1. Burch RC, Loder S, Loder E, Smitherman TA. The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. Headache 2015;55:21-34. 10.1111/head.12482 pmid:25600719. - DOI - PubMed
    1. Spector JT, Kahn SR, Jones MR, Jayakumar M, Dalal D, Nazarian S. Migraine headache and ischemic stroke risk: an updated meta-analysis. Am J Med 2010;123:612-24. 10.1016/j.amjmed.2009.12.021 pmid:20493462. - DOI - PMC - PubMed
    1. Sacco S, Ornello R, Ripa P, Pistoia F, Carolei A. Migraine and hemorrhagic stroke: a meta-analysis. Stroke 2013;44:3032-8. 10.1161/STROKEAHA.113.002465 pmid:24085027. - DOI - PubMed