Stroke and cardiovascular risk factors among working-aged migraineurs

Abstract

Background: The aim of our study was to evaluate the risk for comorbid cardio- and cerebrovascular diseases inthe working-aged migraine population of Finland.Methods: A total of 1505 cases who reported diagnosed migraine and 3010 controls from a cohort of 11,596 casesin the Finnish Health and Social Support Study were included. The study material was linked with two registers. ICDdiagnoses I63 for ischemic stroke (IS), I21 −I22 for acute myocardial infarction (AMI), and G43 for transient ischemicattack (TIA) among study participants were drawn from the national Finnish Care Register for Health Care at thefollow-up in 2012. Reimbursed triptan prescriptions were drawn from the national Social Security Institution (SII)data. The self-reported vascular risk factors were hypertension, high cholesterol values, any diabetes, myocardialinfarction, stroke, and TIA. Odds Ratios (OR) with 95% confidence (95% CI) intervals were assessed for diagnosedstroke, myocardial infarction, and TIA.Results: Migraineurs were mostly female (82%) and ≥54 years old (62%). Triptans were reimbursed among 34.7% ofmigraineurs. A self-reported hypertension (21%), high serum cholesterol (38%), and any diabetes (7%) were morecommon among migraineurs vs controls (p< 0.05). There was no risk for AMI. The risk for TIA (OR 3.20, 95% CI 1.45–7.05) and IS (2.57, 95% CI 1.28–5.17) among migraineurs vs controls remained high after adjustment for self-reported hypertension, obesity, and smoking. The risk was higher among women in two groups ≥54 years (3.25,95% CI 1.35–7.84 and 5.0, 95% CI 1.94–12.89, respectively). The average age for IS in migraine was 57.5 years and forTIA 58.2 years among women, and 52.8 years and 50.3 years among men, respectively.Conclusion: Cardiovascular risk should be screened in the aging migraine population, and hormonal and othermigraine-related risk factors should be considered, especially among women. Efficacious attack treatment withtriptans should be offered to migraine patients who do not show contraindications.Keywords: Migraine, Women, Ischemic stroke, Myocardial infarction, Triptan use