Abstract 4202: Migraine is Associated with Increased Risk of Cardiovascular Disease in Men
Background: The vascular component of the migraine-specific physiology and an observed adverse cardiovascular risk profile among migraineurs suggest an association between migraine and cardiovascular disease (CVD). In women, migraine has recently been associated with increased risk of CVD, including coronary events. Compatible data in men are lacking.
Objectives: To evaluate the association between migraine and subsequent CVD as well as specific CVD events in apparently healthy men.
Methods: Prospective cohort study among 20,084 men participating in the Physicians’ Health Study. In yearly questionnaires, men were asked for information on migraine, risk factors, and the occurrence of study endpoints. We classified men as having migraine if they indicated migraine during the first 60 months, after which follow-up began. Information on aura was not available. All men were free of outcome events at start of follow-up. During 15.7 years, we followed participants for the occurrence of a first major CVD event (nonfatal ischemic stroke, nonfatal myocardial infarction, or death from ischemic CVD). We also evaluated the individual endpoints as well as coronary revascularization and angina.
Results: A total of 1449 (7.2%) men reported migraine and during follow-up 2236 major CVD events occurred. Compared to non-migraineurs, men who reported migraine had multivariable-adjusted hazard ratios (95% confidence intervals) of 1.24 (1.06–1.46; P=0.008) for major CVD, 1.12 (0.84–1.50; P=0.43) for ischemic stroke, 1.42 (1.15–1.77; P<0.001) for myocardial infarction, 1.05 (0.89–1.24; P=0.54) for coronary revascularization, 1.15 (0.99–1.33; P=0.068) for angina, and 1.07 (0.80–1.43; P=0.65) for ischemic cardiovascular death.
Conclusions: In this large prospective cohort of apparently healthy men, migraine was associated with increased risk of major CVD, which was driven by the increased risk of myocardial infarction.