Migraine with aura tied to atherosclerotic disease

  • Magalhães JE & al.
  • Headache
  • 5 Dec 2018

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Migraine with aura is linked to increased carotid thickening in middle-aged women. 
  • Migraine without aura shows reduced risk associated with carotid plaque or arterial stiffening vs women without migraine.
  • Consider carotid ultrasound in women with migraine.

Why this matters

  • These findings add to growing evidence that migraine with aura specifically involves increased risk for cardiovascular disease, including stroke and Afib.

Key results

  • Compared with women with no migraines, those who had migraine and aura had increased risk for diffuse carotid thickening: 3/46 (6.5%) vs 2/165 (1.2%); adjusted OR, 7.12; 95% CI, 1.05-48.49.
  • Compared with women with no migraines, those who had migraine and no aura had: 
    • reduced carotid plaque risk: aOR, 0.28 (95% CI, 0.08-0.99); and 
    • reduced arterial stiffening risk: aOR, 0.39 (95% CI, 0.19-0.79).
  • No associations found for duration, frequency, pain intensity.

Study design

  • Cross-sectional study, 277 (112 with migraine, 46 of them with aura) middle-aged women (median age, 57 [interquartile range, 52-61] years) without known cardiovascular disease.
  • Outcome: migraine feature association with carotid thickening, carotid plaques, arterial stiffening 
  • Funding: None.

Limitations

  • Involved only middle-aged women.
  • Potential treatment confounding.

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