Migraine Study Brings Men New Headaches

Nov. 15, 2006— -- It's not as if migraine sufferers need another headache, but a new study suggests that men who suffer from migraines are at a higher risk of heart problems.

According to the new study, men who experience migraine attacks have a 24 percent increased risk of suffering from major cardiovascular problems and a 42 percent increased risk of suffering a heart attack.

The results of the study, presented at the 2006 American Heart Association meeting in Chicago, reflected the research on 20,084 men who participated in the Physicians' Health Study.

The research complements an older study that found that women who suffer from migraines are also more likely to experience major cardiovascular disease.

"This study and the study in women support the hypothesis that migraine is associated with heart disease," says Dr. Tobias Kurth, assistant professor of medicine at Brigham and Women's Hospital, who led the study.

"The exact reason why migraine may lead to cardiovascular disease, however, is not clear. Suspected mechanisms include an increase in factors that can result in blood clots, as well a genetic factor that can increase homocysteine levels, placing them at higher risk for cardiovascular disease."

A Mysterious Link

"If someone has a migraine, they should be alerted to this new information, that they may be at risk of a heart attack at a higher level than other people," says Dr. Bob Bonow, chairman of the division of cardiology at Northwestern University Medical School and a past president of the American Heart Association.

"They should know the risk factors, and those risk factors should be controlled, perhaps more aggressively than they are being controlled already."

Though the exact nature of the link between migraines and heart disease remains uncertain, evidence suggests that persons who suffer from migraines are at increased risk for hypertension, or high blood pressure, diabetes and hyperlipidemia, which includes conditions such as high blood cholesterol, according to Dr. Richard Lipton, professor of neurology and epidemiology at the Albert Einstein College of Medicine and director of the Montefiore Headache Center, although that "does not fully explain the association," he says.

"One important finding was that patients with the migraines in this study also had higher blood pressure and higher cholesterol than those without a migraine," Bonow says. "So the relationship with a heart attack may only be related to the fact that these individuals had worse risk factors for a heart attack. Those same risk factors may also contribute to the migraine itself."

Identifying and Controlling Triggers

Bonow also says these patients may be at more risk for certain conditions that can increase the likelihood of cardiac problems. "People with migraines may be more prone to constriction of their arteries, or perhaps slightly more prone to developing blood clots in their arteries," he says.

Other factors could also be at play. "Migraine is a disorder whose severity may depend on triggers which associate with increased risk of heart disease, such as sleep apnea, anxiety or even Type A behaviors," says Dr. Alan Finkel, director of the University Headache Center and professor of neurology at the University of North Carolina at Chapel Hill.

"It is very important to take to heart the findings in this study, though they are not proof that migraine is independently associated with cardiovascular disease."

Finkel says that other factors must be studied to understand the true connection between migraines and heart problems. "Lifestyle and family history and BMI [body mass index], et cetera, have yet to be clearly studied in this apparent linkage."

Until the link is better understood, using the presence of migraines to predict future heart problems in individual patients is not yet possible.

Migraine Sufferers Must Keep the Heart Healthy

Though the findings of the study may be grim news for men who experience migraines, doctors say factors other than migraines ultimately play a stronger hand in the occurrence of heart problems.

"Really, the absolute increase in risk here is rather on the small side compared to the biggies, such as high cholesterol, smoking and high blood pressure," Kurth says. "If patients are really concerned about their chances of cardiovascular disease, they should focus on these traditional risk factors first.

"I would tell them exactly what I would tell you," Finkel says. "Live well and exercise and be happy. It's great for migraine and good for your heart, your personal relationships and your sense of well-being in the world."