PHILADELPHIA – Men and women who experience migraine with aura were significantly more likely to die from cardiovascular disease and than were those without headache.
Women with nonmigraine headache were also significantly more likely to die from cardiovascular disease than were women without headache, but the hazard ratio was smaller, Dr. Larus S. Gudmundsson wrote in a poster presented at the annual meeting of the International Headache Society.
Dr. Gudmundsson of the University of Iceland, Reykjavik, and his colleagues used data extracted from the Reykjavik Studyckd, a population-based cohort of adults followed from middle age, representing 474,360 person-years of observation. The cohort comprised 18,882 subjects who were a mean of 53 years old at baseline. Baseline interviews took place between 1967 and 1991.
The investigators divided the cohort into four categories: those without a headache once or more per month; those with nonmigraine headache; those with migraine without aura; and those with migraine and aura. Auras were defined as visual, sensory or both.
Patients with nonaura headache symptoms, including nausea, unilateral location, and photophobia, were placed in the “with migrane without aura” category.
After entering the study, subjects were followed for up to 40 years (mean follow-up 26 years). Statistics on those who died during that time were obtained from the Icelandic government and hospital records.
The Cox regression analysis controlled for age, body mass index, smoking, blood pressure, hypertension medication, oral contraceptive use, diabetes, and lipid levels.
In an assessment of all-cause mortality, both men and women with migraine and aura were at a significantly increased risk of death, compared with subjects without headache (20%).
For men, the risk rose when only cardiovascular death was considered (hazard ratio 1.38). For women with migraine and aura, the risk of cardiovascular death dipped slightly (HR 1.18).
Migraine without aura did not increase the risk of cardiovascular death, compared with those without headache.
However, women with nonmigrainous headaches were at a slightly–though still statistically significant–elevated risk of cardiovascular mortality, compared with women without headache (HR 1.14).
The risk did not change significantly for men with nonmigrainous headache, Dr. Gudmundsson and his colleagues found.
The authors pointed out that the increased risk of death, while significant, was not as great as the risks conferred by other common factors.
“The risk is relatively low when compared with conventional risk factors such as hypertension, high cholesterol, and smoking,” they said.