Men and women with migraine both carry an increased risk of ischemic stroke

Women and men who experience migraine headaches also carry an elevated risk of having an ischemic stroke, but women alone may carry an additional risk of heart attack and hemorrhagic stroke, according to a new study led by Cecilia Hvitfeldt Fuglsang of Aarhus University, Denmark publishing June 13^th in the open access journal PLOS Medicine.

People diagnosed with migraine are believed to have a higher risk of experiencing a heart attack or stroke before the age of 60. Previous studies have suggested that the increased risk of ischemic stroke – when a blood clot blocks a blood vessel to the brain – mostly affects young women. It was unclear whether women with migraine also carry a higher risk of heart attack and hemorrhagic stroke – when an artery in the brain bursts – compared to men, which was the aim of the new research.

Hvitfeldt Fuglsang’s team conducted a nationwide study of Danish medical records collected from 1996 to 2018, from individuals aged 18 to 60. They identified men and women with migraine based on their prescription drug records and compared their risk of a heart attack and ischemic and hemorrhagic stroke before the age of 60 to the risks faced by people in the general population without migraine.

Contrary to earlier findings, the analysis showed that both men and women with migraine had a similarly increased risk of ischemic stroke. However, women with migraine may also carry a slightly higher risk of heart attack and hemorrhagic stroke, compared to men with migraine and the general population.

Overall, the results suggest that women are more greatly impacted by migraine, especially since the condition is predominantly diagnosed in women. The researchers point out that since they used prescription drug records to identify patients with migraine, they may have missed untreated individuals, which could have resulted in an underestimation of the contribution of migraine to these health problems. Since heart attack and stroke can lead to life-long disabilities or even death, the researchers argue that it is vital to identify persons at increased risk to facilitate targeted preventative therapies.

Hvitfeldt Fuglsang adds, “Migraine was associated with a similarly increased risk of ischemic stroke among young men and women.  However, migraine may be associated with an increased risk of myocardial infarction and hemorrhagic stroke only among women.”

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In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004238

Citation: Hvitfeldt Fuglsang C, Pedersen L, Schmidt M, Vandenbroucke JP, Bøtker HE, Sørensen HT (2023) Migraine and risk of premature myocardial infarction and stroke among men and women: A Danish population-based cohort study. PLoS Med 20(6): e1004238. https://doi.org/10.1371/journal.pmed.1004238

Author Countries: Denmark, United Kingdom

Funding: CHF is supported by Aarhus University. The funding source had no role in the study design; data collection, analysis, or interpretation; writing the report; or decision to submit the manuscript for publication.