BERLIN – Do you have older patients who experience migraines with aura? You might want to check their lipid levels.
Older patients who experience migraines with aura may be at increased risk for elevated lipids, particularly total cholesterol and triglycerides, according to the EVA (Epidemiology of Vascular Aging) study.
Migraine with aura has been linked to increased risk of ischemic vascular events, Dr. Tobias Kurth said at the International Headache Congress, which was sponsored by the International Headache Society and the American Headache Society. "Migraine with aura is also associated with increased prevalence of cardiovascular risk factors, including elevated levels of some vascular biomarkers" (Eur. J. Neurol. 2011;18:504-11; Neurology. 2005;64:614-20).
However, "there is a lack of data in the elderly, a group with increased lipids," Dr. Kurth said.
The researchers conducted a cross-sectional study of 1,155 EVA participants with complete lipid and headache information. The patients were classified into groups of three (called tertiles), based on their levels of different blood biomarkers. Their average age was 69 years.
A total of 166 participants had a history of migraine, including 23 who reported migraine with aura. Another 64 had nonmigraine headaches, and the vast majority (925 people) reported no severe headaches. Researchers determined the presence and type of headache through telephone interviews in this longitudinal study.
"There was a strong association with migraine with aura and increasing levels of cholesterol, with nearly a sixfold risk of being in third tertile" of total cholesterol, compared with patients without headache, said Dr. Kurth, director of research in the neuroepidemiology unit at Inserm (Institut National de la Santé et de la Recherche Médicale) in Paris.
Those with migraine with aura had greater adjusted odds (odds ratio, 5.97) of being in the third tertile for total cholesterol. Their risk for being in the second tertile also was greater (OR, 4.67), compared with those without headache.
Researchers also found a strong association between migraine with aura and elevated triglycerides (OR, 4.42 for the third tertile).
The findings confirm previous reports in the literature, Dr. Kurth said. "We observed a pattern consistent with other studies."
Interestingly, the associations held only for migraine with aura. No other headache forms in this elderly population were associated with increased lipid levels, Dr. Kurth said. "Migraine with aura is associated with an unfavorable lipid profile. Migraine with aura could be a marker for increased lipid levels."
A meeting attendee asked if the findings would warrant prescription of statin medication for patients with migraine with aura. "Enough is now published from population-based science that we can try, but I wouldn’t say statins are medications to treat migraine at this point," Dr. Kurth replied.
The large, population-based nature of the study was a strength, Dr. Kurth said. Headache assessment by neurologists via a telephone interview is a possible weakness, he added.
Further targeted research is needed, said Dr. Kurth, who reported that he had no relevant disclosures.