Migraines linked to healthy vascular system despite cardiovascular risk factors

By Dr. Chinta SidharthanReviewed by Danielle Ellis, B.Sc.Oct 23 2024

Study supports the hypothesis that a healthy cardiovascular system may increase the likelihood of migraines, particularly in women.

A recent study published in JAMA Network Open explored the link between cardiovascular risk and migraine activity among Dutch men and women. The researchers used the European Systematic Coronary Risk Evaluation 2 (SCORE2) system to examine whether cardiovascular health influenced migraine patterns and expanded on previous research conducted among women.

Background

Migraine is a neurological condition characterized by moderate to severe headaches and is often accompanied by nausea and sensitivity to light and sound. Patients also sometimes experience aura symptoms. Migraines are most common among women below the age of 50 years and are often disabling.

Growing research suggests that migraine is a cardiovascular risk factor, with studies indicating that migraine with aura symptoms increases the risk of heart disease and stroke. However, other studies have found no evidence linking migraines with cardiovascular disease risk.

A recent study from the United States found that higher cardiovascular disease risk among women was linked to a history of migraines but no active manifestation of migraines. However, whether these findings also apply to men or other populations remains unclear.

About the study

The present study aimed to investigate the connection between cardiovascular risk and migraine activity among a study population of Dutch men and women using the European SCORE2 system that evaluates cardiovascular disease risk.

The study used data from a large population-based study called the Lifelines Cohort that included over 1,60,000 participants from the northern regions of the Netherlands. The participants were older than 18 years, and individuals with severe mental illnesses, terminal illnesses, or language barriers were excluded.

Between 2006 and 2014, the researchers collected baseline data, after which follow-ups involving research visits were conducted every five years. Questionnaires were used to assess migraine symptoms, collect biological samples such as blood, and measure physiological parameters every one and a half to two years. The blood samples were collected from the fasting participants, and an enzymatic colorimetric method was used to measure the cholesterol levels.

The study used the European SCORE2 system of cardiovascular disease risk assessment, which estimates the 10-year risk of fatal and non-fatal cardiovascular disease based on cholesterol levels, age, diabetes, systolic blood pressure, and smoking status. Participants for whom the cardiovascular risk score was incomplete during the study were therefore excluded.

Self-reported questionnaires administered at baseline and during the follow-ups were used to assess migraine symptoms, and based on the responses, the participants were categorized into three groups — those with prevalent migraines, those who developed migraines during the follow-up (known as incident migraine), and those without migraine.

Logistic regression models were used to analyze the relationship between cardiovascular risk scores and migraine status, and the analysis was stratified by age and sex. Furthermore, the researchers conducted a sensitivity analysis using Cox proportional hazard models to examine the risk of incident migraine.

Results

The study found that people with low cardiovascular risk, based on the SCORE2 system assessments, were more likely to experience both prevalent and incident migraine. Specifically, individuals with lower scores in the SCORE2 categories were found to have higher odds of having had migraines in the past or developing them later. While the trend was observed in both men and women, the association was found to be stronger in women.

About 18.4% of the study population reported having prevalent migraine, while 1.9% developed incident migraine during the follow-up. Notably, as the cardiovascular risk increased, the likelihood of having already had or developing migraines was found to decrease.

Compared to individuals who had a cardiovascular risk of 1.0% on the SCORE2 assessment categories, those with prevalent migraine had a 7% lower likelihood of having SCORE2 values between 1.0% and 2.5%. Similarly, individuals with higher cardiovascular risk scores had an 83% lower likelihood of developing migraines.

Furthermore, this association was observed regardless of age, indicating that age was not a determining factor in the link between lower cardiovascular risk and a higher likelihood of developing migraines. However, women showed a stronger association between the two parameters than men, indicating potential sex-based differences in the association between cardiovascular health and migraines.

Conclusions

Overall, the findings indicated that among the European population, lower cardiovascular disease risk was associated with a higher likelihood of a history of migraines and the probability of developing migraines.

The association was observed for both men and women but was stronger among women, indicating that although age was not one of the determining factors, sex-based differences existed for the association.