Women Who Experience Migraines Have an Elevated Stroke Risk

Researchers revealed that women who experience migraine headaches may have an increased risk of heart attack and a specific type of stroke.

Migraine headaches impact about one out of six people in the United States. However, women are three times more likely to experience migraines than men.

Although scientists aren't sure what causes migraines, some believe blood vessel constriction or inflammation in the brain may play a role. Still, recent research suggests that migraine headaches are linked to genes that influence circadian rhythms.

Scientists have also found links between migraine headaches and other health conditions, including depression, asthma, and fibromyalgia. Moreover, people with migraines might also have an increased risk of stroke or heart attack.

To investigate these potential cardiovascular risks, a recent nationwide population-based cohort study took a closer look at migraine stroke risk among men and women.

The research, published in PLOS Medicine, suggests that while both men and women with migraines may have an elevated risk of ischemic stroke, women are at slightly greater risk of experiencing a hemorrhagic stroke or heart attack than men.

Using Danish medical registries and redeemed migraine prescription data, scientists identified 179,680 women and 40,757 men with migraine headaches from 1996 to 2018. The participants were 18 to 60 years old, with an average age of 40. The scientist matched the participants to individuals without a history of migraines.

The researchers compared the incidence of premature heart attack, ischemic, and hemorrhagic stroke among participants with migraines and without. Hemorrhagic stroke results from bleeding in the brain, whereas ischemic stroke happens when a blood clot blocks blood flow to the brain.

After examining the data, the researchers found that among the participants, migraines were associated with similar increases in the risk of premature ischemic stroke for men and women. However, only women had an increased risk of early heart attack or hemorrhagic stroke. Still, the scientists say the overall risk is low.

Why would migraine headaches increase stroke and heart attack risk?

The study authors suggest several factors may play a role in the associations between migraine and stroke or heart attack.

These include:

• Cortical spreading depressions in the brain associated with migraine with aura could reduce the brain’s blood supply.
• Migraine is associated with patent foramen ovale (a hole between the heart's chambers) and higher levels of von Willebrand factor, which might increase the risk of ischemic stroke.
• A link might exist between migraines and the constriction of coronary arteries, which suggests migraine headaches may affect the vascular system.
• Medication to treat migraine, like sumatriptan, may play a role in stroke and heart attack risk.
• For women, estrogen may be a factor, as scientists have found links between this hormone and stroke and cardiovascular risks among females.

Cardiovascular risk factors associated with migraine, such as high blood pressure, obesity, smoking, and nonsteroidal anti-inflammatory drug (NSAID) use, may also contribute to the elevated risks found in the study.

Although the overall migraine stroke risk among women is low, the study authors wrote, "Given that migraine is much more prevalent in women (approximately 179,000 women versus approximately 40,000 men with migraine in this population-based study), the presence of migraine will likely result in a greater migraine-associated disease burden in society for women."