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. 2010 Aug 24:341:c3966.
doi: 10.1136/bmj.c3966.

Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study

Larus S Gudmundsson  1 , Ann I Scher, Thor Aspelund, Jon H Eliasson, Magnus Johannsson, Gudmundur Thorgeirsson, Lenore Launer, Vilmundur Gudnason
Affiliations

Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study

Larus S Gudmundsson et al. BMJ. .

Abstract

Objective: To estimate whether migraine in mid-life is associated with mortality from cardiovascular disease, other causes, and all causes.

Design: Population based cohort study.

Setting: Reykjavik, Iceland.

Participants: 18,725 men and women, born 1907-35 and living in Reykjavik and adjacent communities.

Main outcome measures: Mortality from cardiovascular disease, non-cardiovascular disease, and all causes. Questionnaires and clinical measures were obtained in mid-life (mean age 53, range 33-81) in the Reykjavik Study (1967-91). Headache was classified as migraine without aura, migraine with aura, or non-migraine headache. Median follow-up was 25.9 years (0.1-40.2 years), with 470,990 person years and 10,358 deaths: 4323 from cardiovascular disease and 6035 from other causes. We used Cox regression to estimate risk of death in those with migraine compared with others, after adjusting for baseline risk factors.

Results: People with migraine with aura were at increased risk of all cause mortality (adjusted (for sex and multivariables) hazard ratio 1.21, 95% confidence interval 1.12 to 1.30) and mortality from cardiovascular disease (1.27, 1.13 to 1.43) compared with people with no headache, while those with migraine without aura and non-migraine headache were not. Further examination of mortality from cardiovascular disease shows that people with migraine with aura were at increased risk of mortality from coronary heart disease (1.28, 1.11 to 1.49) and stroke (1.40, 1.10 to 1.78). Women with migraine with aura were also at increased risk of mortality from non-cardiovascular disease (1.19, 1.06 to 1.35).

Conclusions: Migraine with aura is an independent risk factor for cardiovascular and all cause mortality in men and women. The risk of mortality from coronary heart disease and stroke mortality is modestly increased in people with migraine, particularly those with aura.

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Conflict of interest statement

Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that no company has supported the submitted work; LSG has received a travel grant from the Pharmaceutical Society of Iceland Science Fund, AIS has served on advisory boards for Endo Pharmaceuticals and OrthoMcNeil Neurologics, has received an honorarium and a travel grant from the National Headache Foundation and a travel grant from the American Headache Society; no other relationships or activities that could appear to have influenced the submitted work.

Figures

None
Migraine status and Nelson-Aalen cumulative hazards for mortality from cardiovascular disease. For men and women curve for non-migraine headache overlays curve for no headache and was therefore omitted
See this image and copyright information in PMC

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