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Migraine with aura a major risk factor in women

Tuesday January 15, 2013
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Women who have migraines with aura appear to be at higher risk of heart health problems, according to a study.

Migraine with aura is a strong contributor to the development of major cardiovascular events such as myocardial infarction and stroke, according to data from the Women’s Health Study, which involved 27,860 women, 1,435 of whom had migraine with aura. During the 15-year study, there were 1,030 cases of MI, stroke or death from a cardiovascular cause. Researchers examined the relative contribution of different vascular risk factors.

Among the women in the study, migraine with aura was associated with more CVD events than any other risk factor except systolic blood pressure at or above 180 mg/Hg. Migraine with aura was associated with more CVD events than diabetes, family history of MI, current smoking and obesity.

Study author Tobias Kurth, MD, ScD, of INSERM (the French National Institute of Health and Medical Research) and Brigham and Women’s Hospital in Boston, and a member of the American Academy of Neurology, said people with migraine with aura can reduce their risk in the same ways others can, such as by not smoking, keeping blood pressure low and weight down, and exercising.

The study is scheduled for presentation at the American Academy of Neurology’s annual meeting March 16-23 in San Diego. The study abstract is available at www.aan.com/globals/axon/assets/10436.pdf.

Thrombotic events

A second study, scheduled for presentation at the same conference, involved women with migraine who took hormonal contraceptives, examining whether those women faced an increased risk of blood clots. The study included women with migraine with and without aura who were taking both newer contraceptives, such as the contraceptive patch and ring, and older contraceptives. Of the 145,304 women who used contraceptives, 2,691 had migraine with aura and 3,437 had migraine without aura.

Women who had migraine with aura were more likely to have experienced blood clot complications such as deep vein thrombosis with all types of contraceptives than women who had migraine without aura. For example, 7.6% of women who had migraine with aura and who used a newer-generation combined hormonal contraceptive had deep vein thrombosis, compared with 6.3% of women who used such a contraceptive and had migraine without aura — although the researchers said the timing of the two events is not clear.

The occurrence of thrombotic events also was higher in women with migraine who took contraceptives than in women who did not have migraine and took contraceptives.

"Women who have migraine with aura should be sure to include this information in their medical history and talk to their doctors about the possible higher risks of newer contraceptives, given their condition," study author Shivang Joshi, MD, MPh, RPh, of Brigham and Women’s Falkner Hospital and a member of the American Academy of Neurology, said in a news release.

The study abstract is available at www.aan.com/globals/axon/assets/10435.pdf.

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