Migraine with aura may increase heart attack risk

NEW YORK (Reuters Health) - An analysis of data from the Women's Health Study reveals an increased risk of heart attack and stroke among women who have migraine headaches with aura. In contrast, women who have migraine without aura do not appear to be at increased risk.

Auras are symptoms that signal the onset of a migraine attack. They can vary from patient to patient, but are often visual in nature, such as seeing flashing lights or zigzag lines.

In their paper in the Journal of the American Medical Association, Dr. Tobias Kurth, from Harvard Medical School in Boston, and associates note that an association between migraine with aura and stroke has been well documented. In contrast, the relationship between migraine with aura and heart attacks has not been established.

They therefore examined documented events among 27,840 women age 45 or older without a history of heart attack or stroke when they enrolled in the WHS between 1992 and 1995. Of 3,610 women with active migraine, defined as migraine occurring during the year prior to enrollment, 1,434 reported an accompanying aura.

During 10 years of follow-up, 251 patients had a stroke, 249 had a heart attack and 130 died from related causes.

Compared with women with no migraine history, the risk for heart attack and stroke among women with active migraine with aura was approximately doubled. In contrast, women with active migraine without aura showed no increased risk for heart attack or stroke.

In a related editorial, Dr. Richard B. Lipton and Dr. Marcelo E. Bigal propose genetic factors may predispose patients to heart attacks and strokes, as well as migraine with aura.

Even though these findings need to be reproduced and assessed in men and in younger women, the editorialists from Albert Einstein College of Medicine in New York, recommend that doctors have heightened vigilance for risk factors that can be modified, such as smoking, to reduce the risk of heart attack and stroke in migraine with aura patients.

SOURCE: Journal of the American Medical Association, July 16, 2006.