Impact of migraine on changes in cardiovascular health profile among Hong Kong Chinese women: insights from the MECH-HK cohort study

Abstract

Background: Previous research has shown an association between migraine and cardiovascular diseases (CVDs). However, limited studies have explored the progression of cardiovascular health (CVH) among individuals with migraine. This cohort study aimed to explore the relationship between changes in CVH and migraine among women of Chinese descent in Hong Kong.

Method: Data from a cohort study titled "Migraine Exposures and Cardiovascular Health in Hong Kong Chinese Women (MECH-HK)" were analysed. A total of 2,603 women, averaging 56.5 ± 8.5 years of age, were selected, all with complete data at baseline and at a follow-up occurring on average 1.27 years later. CVH profile was assessed by an adapted Life's Essential 8, comprising dietary habits, physical activity, nicotine exposure, sleep duration, body mass index (BMI), lipid levels, blood pressure, and stress. Each component was scored from 0 to 100, with overall CVH as the average. CVH levels were categorized as low (0-49), moderate (50-79), and high (80-100), representing poor to excellent health. Changes in CVH were defined as shifts between these categories from baseline to subsequent follow-up. Migraine cases were identified utilizing the International Classification of Headache Disorders 3.

Result: A total of 275 (10.6%) women were identified as having migraine. By follow-up, both women with and without migraine experienced significant declines in CVH profiles (all p-value < 0.05). In the fully adjusted model, women with migraine had a 1.36 times higher risk (OR 95% CI: 1.33, 1.39) of decline in overall CVH compared to non-migraineurs. They also had a higher likelihood of shifting to worse CVH levels in several individual CVH components, including physical activity (OR: 1.09), nicotine exposure (OR: 4.27), sleep quality (OR: 1.80), blood lipid levels (OR: 1.03), and stress (OR: 1.23) (all p-value < 0.05). Among women with migraine, those experiencing aura had a higher risk of poorer physical activity, greater nicotine exposure, higher BMI, and increased stress than those without aura (all p-value < 0.05).

Conclusion: Women with migraine exhibited worse progression in CVH compared to those without migraine. Targeted monitoring and management of CVH-related factors in this population are crucial to reducing their elevated risk of CVDs.

Keywords: Adapted Life’s Essential 8; Cardiovascular health profile; Migraine.

Fig. 1

Data collection and screening flowchart for analysing the relationship between migraine and CVH profile changes in the MECH-HK cohort study (October 2019 - June 2023)

Fig. 2

Overall CVH scores and changes in CVH profile from baseline to the follow-up for migraineurs and non-migraineurs. (A) Violin plot for the distribution of overall CVH scores for migraineurs and non-migraineurs at baseline and follow-up. (B) Bar plot for the percentage of participants whose overall CVH category or individual components either increased, remained stable, or decreased from baseline to follow-up