Migraines Increase Your Risk of Heart Disease and Strokes
Migraine headaches increase your risk for heart attacks and stroke, but you can take several steps to lower your personal risk. Here's what you can do.
A migraine is not simply a bad headache. It’s a collection of neurological symptoms that affects the quality of life for millions of Americans. According to the American Migraine Foundation, a quarter of all U.S. households include someone who gets migraines. It affects about three times as many women as men.
When a migraine strikes, throbbing head pain, dizziness, and nausea can keep you in bed with the curtains drawn and the lights off. It can interfere with work for hours or even days.
About 20 percent of people who get migraines also experience visual symptoms, such as flashing lights and zigzagging lines or blind spots. These symptoms typically occur about 20 minutes before a migraine headache strikes, according to the National Headache Foundation.
Tingling and pins-and-needles sensations in one arm or leg can also be part of an aura. Some people have migraine auras without head pain.
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Heart disease and auras
Migraines seem to raise your risk of both strokes and heart attacks — for example, doubling your risk of ischemic stroke, the most common kind, in people who see auras.
It's less clear whether migraines increase your risk of hemorrhagic strokes, but if they do the link seems strongest in women younger than 45.
Migraines also appear to be linked to higher risk of high blood pressure, blood clots in veins, and atrial fibrillation, particularly in those who see auras.
For example, in a study of nearly 28,000 women aged 45 and up, women who had migraines with auras were more likely — than both those who didn’t see auras and those with no migraines — to have some kind of cardiovascular event during the average follow-up of nearly 23 years.
Why this might be is unclear. It’s possible that blood flow to small areas of the brain dip during a migraine with an aura, triggering inflamed blood vessels. Another possibility is that the genes that cause migraines also affect the heart.
Researchers from Harvard and the Massachusetts Institute of Technology (MIT), however, didn’t find shared gene variants that would explain the overlap between the two health problems in people who see auras.
Migraine without aura and heart disease did share some genetic variations, but the team was surprised to find that those shared genes actually protected against heart disease.
"We now need to understand why people with migraine who are born with a protective or neutral genetic risk for heart disease end up with an increased risk for heart problems,” said Anne Ducros, MD, PhD, of the University of Montpellier in France, who wrote an editorial accompanying the study.
The researchers concluded it is possible still undiscovered genetic factors could play a role in the link between migraine and heart disease, but there could be another reason for the association — and it could be good news for migraine sufferers.
What you can do
Migraine sufferers shouldn’t feel doomed. As Christopher Anderson, MD, chief of stroke and cerebrovascular diseases at Harvard-affiliated Brigham and Women's Hospital, notes, "Migraines tend to be most common in younger women, and their baseline risk of stroke is quite low in the first place.”
For people with migraines, and for all of us, good health habits lessen the risk of stroke and heart attacks.
"Migraine has been associated with obesity, avoidance of exercise, smoking, and depression, all of which increase the risk of heart disease," Ducros said.
If you are a migraine sufferer, one of the smartest moves you can make to protect your health is to stop smoking or never start. The risk of stroke is tripled for smokers and increases seven times if you smoke and take birth control pills.
Your migraines are also another reason to exercise, treat depression, and manage your weight.
January 12, 2023
Christopher Nystuen, MD, MBA and Janet O'Dell, RN