Study observes increased risk for CV events in men with migraines

Men who suffer from migraines are at increased risk for cardiovascular (CV) events, according to new data from the Physicians' Health Study. These observations follow similar reports that women with symptoms associated with migraines are at higher risk for CV disease.

"This does not mean that people with migraines should panic," said Tobias Kurth, MD, ScD, associate epidemiologist at Brigham and Women's Hospital, Boston, Mass, and assistant professor of medicine at Harvard Medical School. Dr Kurth led the study team that produced both findings, which he presented at the American Heart Association Scientific Sessions 2006 in Chicago, Ill.

"We do not know how or why migraines are associated with increased cardiovascular risk," Dr Kurth said. "Physicians and patients with migraines should pay even more attention to traditional cardiovascular risk factors such as high blood pressure, diabetes, cholesterol, smoking, and obesity."

At the beginning of the study, men with migraines were observed to have a slightly higher prevalence of hypertension and hypercholesterolemia. Analysis of >15 years of health data controlled for both of these pre-existing factors, Dr Kurth said.

The data are similar to those from the Women's Health Study. The major difference is that increased CV risk in women is associated with migraine aura, the visual and neurologic disturbances that frequently precede a migraine attack. The Physicians' Health Study did not question male subjects about aura because when the study was designed, researchers were not yet aware of the potential relationship between migraines and CV disease.

"This study and the study in women support the hypothesis that migraine is associated with heart disease," Dr Kurth said. "The mechanism behind the association is not at all clear. Suspected mechanisms include an increase in thrombolytic factors and inflammatory factors."

He added, "The reality is that we don't really know. Physicians should continue to emphasize modifying other risk factors with their patients."