By: Dr. Holly Andersen
Don’t have a heart attack reading this: A large study published today in the Journal of Neurology reports an association of migraine headaches with an increased risk of heart disease and stroke.
Migraines afflict nearly 28 million Americans with a 3:1 female predominance. It is usually characterized as a chronic condition, associated with recurring, intense, throbbing and mostly unilateral headaches. Although incompletely understood, migraines are felt to be due to the “vasodilation” or enlargement of blood vessels flowing into the brain. When these blood vessels dilate, they stretch surrounding nerve cells, which in turn release neurotransmitters or chemicals that can cause pain, inflammation and further enlargement of the arteries.
Nearly one quarter of migraines are associated with an “aura.” Most often this aura is characterized by visual disturbances, such as zigzagging patterns, flashes of light or blind spots. Occasionally, tingling or numbness usually in the face or hands occurs. Auras most often precede the headache, and classically have been felt to be due to the “vasoconstriction” or narrowing of the brain’s arteries that occurs right before the vasodilation.
If having migraine headaches isn’t bad enough, there has been significant research to link migraines with aura to an increased risk of cardiovascular disease, especially ischemic stroke. There is also research less strongly linking migraine with aura to an increased risk of coronary heart disease, peripheral arterial disease and cardiovascular death. It has never been clear whether migraines with aura are a risk factor for developing cardiovascular disease or just a marker of the disease.
Today’s report from the American Migraine Prevalence and Prevention study further establishes this association. This study of 11,345 adults with and without migraines found that not only migraine with aura – but also migraine without aura – was associated with an increased risk of cardiovascular disease. Migraine with aura was associated with a stronger increased risk of heart attack, stroke and peripheral arterial disease. But migraine without aura was also associated with an increased risk of heart attack and peripheral arterial disease.
It is very important to understand, however, that the migraine does not cause a stroke or heart attack. Previous similar reports in the media caused unnecessary worry and panic among migraine sufferers. I look at this as an opportunity. It is heart month, and we are busy talking about ways to prevent this disease – the No. 1 killer of both men and women. If we can identify individuals who may have an increased risk of future heart attacks and stroke, then we can intervene earlier and more aggressively to prevent them. If you suffer from migraines (and even if you don’t), speak to your doctor about your risk factors for cardiovascular disease, and get a plan to reduce your risk. Anything that is good for your heart is good for the rest of you – and can improve your quality of life too.