The latest on migraine and stroke

Not sure what this means for people who have migraine without aura, but here's the bad news:

BOSTON, Massachusetts — Migraine with aura is just as strong a stroke risk factor as elevated systolic blood pressure, obesity, and smoking, a new study suggests.

"I'm really comparing migraine with aura to hypertension, obesity, diabetes, etc, and the results indicate that migraine with aura is a very strong relative contributor to all subtypes of stroke when you take the other major risk factors into account," said lead author Tobias Kurth, MD, director of research, Neuroepidemiology, Institut national de la santé et de la recherche médicale (INSERM), Bordeaux, France, adjunct associate professor of epidemiology, Harvard School of Public Health, and associate epidemiologist, Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

"A history of migraine with aura should be considered an important risk marker for strokes of any kind," the authors conclude.

Dr. Kurth presented his research here at the 2013 International Headache Congress (IHC).

Strong Contributor

The prospective cohort study included 27,860 women aged 45 years and older who were participating in the Women's Health Study and were free of cardiovascular disease at baseline. The women provided information on migraine and lipid measurements.

At the beginning of the study, 5130 women reported migraine, 40% of whom reported migraine with aura. During a 15-year follow-up, researchers confirmed 528 strokes: 430 ischemic, 96 hemorrhagic, and 2 unknown. The overall incidence rates per 1000 women per year were 1.2 for total stroke, 1.0 for ischemic stroke, and 0.2 for hemorrhagic stroke.

Migraine with aura was a strong contributor of risk for any type of stroke, with the incidence rates per 1000 women per year, adjusted for numerous variables, similar to those of other known risks factors, including systolic blood pressure of 180 mmHg or greater, body mass index of 35 kg/m2 or more, history of diabetes, family history of myocardial infarction, or smoking.

"Our data show migraine with aura is at least as strong as systolic blood pressure of 180 mm Hg , being heavily obese, having a history of diabetes, or current smoking, so it holds up with the biggies," commented Dr. Kurth. "That's a new piece that we haven't looked at before."

He added that migraine with aura is "not as a minor risk factor as we thought."

It means you really, really need to try to reduce your other risk factors if you have migraine with aura. Loose weight if necessary, get your blood sugar and blood pressure down, etc. (All of which I need to do!)

And, I suspect, work hard at controlling the migraines if possible.

Being a male that gets migraines w/o aura, I have to wonder about the impact of this research.

I also have to wonder if it not really due to the effects of vaso-active amines like tyramine and MSG. They get onto the blood stream of people that get food induced migraines. They jack up their blood pressure because of low levels of MAO in the GI tract and/or blood stream that would otherwise bind with these amines and make them inactive. Vaso-active amines like tyramine and MSG are known causes of problems for men with BPH for that reason.