According to the first large population-based study showing a link between migraine and overall mortality as well as specific mortality, people who suffer from migraines with aura—the temporary visual or sensory disturbances before or during a migraine headache—are at a higher risk of dying from heart disease or stroke. Just published on bmj.com, the findings support increasing evidence that migraine, particularly with aura, is associated with death from heart disease. The authors, led by Larus Gudmundsson from the University of Iceland, assessed the impact of mid-life migraine episodes in 18,725 men and women born between 1907 and 1935 who took part in the Reykjavik Study (set up in 1967 by the Icelandic Heart Association to study heart disease in Iceland). In total the research team explored over 470,000 person-years of data with a follow-up of 26 years and used questionnaires to assess migraine with and without aura. The results concluded that men and women who suffered from migraine with aura were at an increased risk of dying from all causes, as well as heart disease and stroke, while those with migraine without aura were not at increased risk. Furthermore, the study says that women who experience migraine with aura are also at a higher risk of dying from causes other than cardiovascular disease or cancer. "However, it remains to be seen which diseases drive the risk increase seen for women with migraine," say the researchers. A second paper, also published on bmj.com, finds that female sufferers of migraines with aura are also at a higher risk of hemorrhagic stroke where bleeding occurs in the brain (these account for around 20 percent of all strokes). However, lead author, Dr Tobias Kurth, Director of Research at INSERM, says that further research is required to confirm these findings.
The news isn’t all grim—lead authors of both studies conclude that the individual risks faced by migraine sufferers are low. While there is concern that the study information could cause unwarranted anxiety among migraine sufferers, it also gives them the opportunity to modify their lifestyle and increase efforts to reduce heart disease and other chronic illnesses by focusing on traditional risk factors such as high blood pressure, smoking and high cholesterol, regardless of migraine status. The researchers also call for more study on the association between migraine and death from cardiovascular disease and all other causes. "Studies are needed to determine if reducing the frequency of attacks with migraine preventive treatment might reduce the risk of cardiovascular disease," they add.