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. 2025 Feb;32(1):135-141.
doi: 10.1007/s12529-023-10241-7. Epub 2023 Nov 16.

Association of Migraine and Blood Pressure-Does Obesity Severity Have a Moderating Role?

Siddhartha S Kalala #  1 , Leah M Schumacher #  2 , J Graham Thomas  3 , Richard B Lipton  4 , Jelena Pavlovic  4 , Dale S Bond  5
Affiliations

Association of Migraine and Blood Pressure-Does Obesity Severity Have a Moderating Role?

Siddhartha S Kalala et al. Int J Behav Med. 2025 Feb.

Abstract

Background: The relationship between migraine and blood pressure (BP) is equivocal, warranting exploration of potential moderators. Obesity associates with both migraine and BP in a dose-dependent fashion, although its role as a moderator has not been evaluated. We examined the relation between migraine and BP in women with comorbid migraine and obesity, and whether this relation was influenced by obesity severity.

Methods: Women with migraine and obesity (n = 134) completed a 28-day headache diary before randomization to lifestyle intervention or migraine education. BP (systolic (SBP)/diastolic (DBP)), body mass index (BMI), and waist circumference (WC) were measured before diary completion. Hierarchical linear regression assessed associations between BP and migraine characteristics (headache frequency, duration, and pain intensity), and obesity severity (both total (BMI) and abdominal (WC)) as moderators of these associations.

Results: Participants (BMI = 35.4 ± 6.5 kg/m2; WC = 105.4 ± 15.6 cm, SBP = 113.1 ± 12.1/DPB = 68.1 ± 8.0 mmHg) reported 8.4 ± 4.5 migraine days that lasted 20.2 ± 15.9 h with mean pain intensity of 5.9 ± 1.6 on a 10-point scale. DBP inversely related to migraine days in both total (β = - 0.226, p = .010) and abdominal (β = 0.214, p = .015) obesity severity models. SBP and obesity severity did not relate to migraine characteristics. Obesity severity did not moderate relations between migraine characteristics and BP (p's > .05).

Conclusion: Among women with comorbid migraine and obesity, DBP inversely related to migraine frequency; however, obesity severity did not affect the strength of this or other examined associations. Future studies including healthy weight controls and men and women with continuous BP measures are needed to confirm these findings and identify mechanisms and moderators.

Keywords: Blood pressure; Migraine; Obesity; Women’s health.

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Conflict of interest statement

Declarations. Ethical Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed Consent: Informed consent was obtained from all participants. Conflict of Interest: LMS reports grant funding from NIH. JGT reports grant funding from NIH; scientific advisory board participation for Medifast, Inc.; and scientific advisory board participation, consulting fees, and stock options for Lumme Health, Inc. JP reports grant funding from NIH and consulting honoraria from Allergan Inc, Alder, Amgen, and Biohaven. DSB reports grant funding from NIH and travel and conference support from the American Headache Society. RL receives research grant support from the NIH, Migraine Research Foundation, National Headache Foundation and TEVA, Satsuma, and Amgen; holds stock and stock options in Biohaven Holdings as well as stock options in Manistee; serves as consultant and advisory board member or has received honoraria from Abbvie (Allergan), American Academy of Neurology, American Headache Society, Amgen, Avanir, Axsome, Biohaven, Biovision, Boston Scientific, Dr. Reddy’s (Promius), Electrocore, Eli Lilly, eNeura Therapeutics, Equinox, GlaxoSmithKline, Grifols, Lundbeck (Alder), Merck, Pernix, Pfizer, Satsuma, Supernus, Teva, Trigemina, Vector, and Vedanta; and receives royalties from Wolff’s Headache 7th and 8th Edition, Oxford Press University, 2009, Wiley, and Informa.

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