Migraine and vascular disease

In the linked paper (doi:10.1136/bmj.i2610), Kurth and colleagues examine the link between migraine and cardiovascular events by using data from the Nurses’ Health Study II. The study followed a large cohort of female nurses for more than 20 years, 17 531 of whom reported a physician’s diagnosis of migraine at baseline. When compared with participants without migraine, those with migraine had an elevated risk of myocardial infarction, angina, or coronary revascularization and of cardiovascular mortality. Their relative risk for the combined outcome of all those events or stroke was roughly 50% higher than that for women without migraine, an effect that was not modified by age.1

Not all of these findings are new. The elevated risk of stroke in people with migraine is well established, for example. This increased risk of stroke is driven by and probably limited to the roughly 30% of people with migraine who experience aura—a focal neurologic event that usually precedes the headache. Migraine is associated with a roughly …