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Migraine, heart disease, and stroke

You’ve probably seen lots of lists of risk factors for heart disease and strokes. High blood pressure, being overweight, not exercising, using tobacco products, and having a high cholesterol or diabetes are all important factors that increase your risk for vascular disease. Many studies have shown that having migraine—particularly migraine with aura—increases your risk for heart disease or stroke:

  • Two studies published in the British Medical Journal in 2009 and the American Journal of Medicine in 2010 showed stroke risk was doubled in people with migraine, especially with migraine with aura
  • A study published in the journal Neurology in 2010 reported migraine was linked to a 1½ times risk for stroke and twice the risk for heart attacks
  • New studies being presented at the American Academy of Neurology meeting this March will likewise link migraine with aura with an increased risk of heart attack, stroke, and blood clots

Before you feel totally discouraged by these reports—there’s more to the story than just having a risk factor you can’t do anything about. I think the more important information from these studies is what else they found linked to migraines. Studies show that migraineurs have a higher risk for having other risk factors that are strongly linked to heart disease. The risk for these other factors is highest among people with migraine with aura, but is also found in people with migraine without aura. Here are examples from two studies:

  • The Neurology 2010 study described above found:
    • 13 percent of people with migraine have diabetes compared with 9 percent of those without migraine
    • High blood pressure occurs in 33 percent with migraine and 28 percent without migraine
    • High cholesterol is found in 33 percent with migraine and 26 percent without
    • In summary, people with migraine are 40 percent more likely to have diabetes, hypertension, or high cholesterol
  • A new study that will be be published later this year in the journal Cephalalgia likewise found more heart disease risk factors among migraineurs:
    • 6 percent of people with migraine had diabetes versus 3 percent without migraine
    • 49 percent with migraine with aura and 41 percent with migraine without aura smoked compared with 31 percent of people without migraines
    • High density lipoprotein (HDL) cholesterol — the “good” cholesterol — was significantly lower among those with migraine with aura compared with those without migraine

These studies teach us several important things:

Knowing you have migraine can be the added push you need to keep you motivated to stay heart healthy.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • sorchajayne
    6 years ago

    The post says that a higher percentage of migraine sufferers smoke compared to those who don’t. Is this taken into account when calculating the other risk factor? For instance, is the increase in heart disease down to the smoking or the migraine?

  • Dr Marcus author
    6 years ago

    Sarahajayne — the increased risk is probably from both inherited and environmental factors. Increases in vasular reactivity in migraineurs is likely a factor, but the more substantial factors are thought to be that migraineurs have higher risks for other factors, like high blood pressure, excess weight, smoking, diabetes, etc. Excess fat, for example, increases the body’s inflammatory state — which makes you more sensitive to pain. For this reason, obesity is a risk factor for many types of chronic pain. Another weight factor is that many medications used to treat migraine and pain can increase weight. It really doesn’t matter if the excess weight came first or the migraines — carrying that excess weight is likely a factor aggravating pain. How much of a factor will vary among different people, although it’s unlikely your migraines will go away by simply losing excess weight. The same with smoking. Migraineurs are more likely to smoke and migraineurs who start smoking will likely find the nicotine aggravates their attacks. Quitting smoking may make your migraines somewhat better, but they won’t likely go away. When studies look at migraine and heart disease/stroke risk, these factors also come into play and it’s the whole package of all of one’s risk factors that makes the difference. The important message to come out of the research is that the other risk factors — like smoking, high blood pressure, etc. — that you can work to change are stronger factors increasing risk for heart disease and stroke compared with just being a migraine sufferer without those other risk factors.For this reason, doctors may be especially vigilant about getting these other risk factors down when you’re a migraineur.

  • jamesbogash
    7 years ago

    Dr. Marcus,
    Thanks for the contribution to this issue. My frustration seems to center around the idea that the vascular issues (CVD) are comorbidities. However, the reserach supporting a vascular dysfunction model of migraines is strong, leading to the concept that migraine, heart disease and stroke all stem from the same vascular dysfunction. The lifestyle changes you noted will improve vascular function, improving the spectrum of downstream problems. I have had countless patients who have made significant lifestyle changes and have drastic reductions in his or her migraine headaches.
    Once again, thanks for the article.

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