Migraine with aura linked to heart risks

25^th August 2010 - People who suffer from migraines with aura - temporary visual or sensory disturbances - are at a higher risk of dying from heart disease or stroke, according to new research.

The Icelandic researchers do stress, however, that despite the higher statistical risks, the individual risk for a migraine sufferer remains low.

The study

The University of Iceland team looked at the impact of mid-life migraine episodes in 18,725 men and women born between 1907 and 1935 who took part in an Icelandic Heart Association study.

They used questionnaires to assess migraine with and without aura.

They found that men and women who suffered from migraine with aura were at a modestly increased risk of dying from all causes, including stroke, as well as from heart disease, while those with migraine without aura were not at increased risk.

This is the first large population-based study showing a link between migraine and overall mortality as well as mortality to a specific condition, in this case heart disease.

The findings, published at bmj.com, support increasing evidence that migraine, particularly with aura, is associated with death from heart disease.

Other risks

The study also found that women who experience migraine with aura are also at a higher risk of dying from other causes, except cancer. However, they haven’t identified which diseases drive the risk increase seen for women with migraine.

The researchers say that because the individual risk faced by migraine sufferers is low, efforts to reduce heart disease deaths should focus on conventional risk factors such as high blood pressure, smoking and high cholesterol, whether or not people suffer from migraines.

The Icelandic team say further work is needed to see if reducing the frequency of attacks with migraine preventive treatment might reduce the risk of cardiovascular disease.

Haemorrhagic stroke

A second paper by French and US researchers, also published at bmj.com says female sufferers of migraines with aura are also at a higher risk of haemorrhagic stroke - bleeding in the brain.

Their study looked at 27,860 women in the US of whom 85 had haemorrhagic strokes.

Because of the relatively low number of strokes, the researchers caution against making definitive conclusions at this stage.

Reaction

In an editorial to go with the first study, Dr Klaus Berger from the University of Muenster in Germany questions whether doctors should tell patients who have migraine with aura about the heart risks. He writes: “For many people the information will cause an unwarranted amount of anxiety, although others may use the opportunity to modify their lifestyle and risk factors accordingly.” He continues, “Clinicians must carefully weigh the decision whether or not to discuss the risks related to this condition.”

Also commenting on the first study, Judy O’Sullivan, Senior Cardiac Nurse at the British Heart Foundation, says in a statement: “This study identifies a small increased risk of death from heart and circulatory disease for anyone who suffers from migraine with aura.

“Like everyone else, those affected should be vigilant when it comes to spotting signs of a heart attack, and should call 999 for an ambulance immediately if they’re worried.

“They should also reduce their risk of heart disease in the future by avoiding smoking, regularly exercising and eating a balanced diet.”