Migraine, Persistent VMS Tied to Higher Risk of CVD, Stroke: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in Menopause that examined whether vasomotor symptoms (VMS) and migraine are associated with higher risk for cardiovascular disease (CVD) events, including stroke.

The study

Investigators included 1954 women with 15-year follow-up data in the CARDIA study, which began data collection at 18 to 30 years of age and continued up to age 61.

Specifically, investigators analyzed whether history of migraine and VMS trajectories (characterized as minimal, increasing, persistent) at CARDIA year 15 examination were jointly associated with higher risk of CVD events and stroke (both ischemic and hemorrhagic). They adjusted for reproductive factors and traditional CVD risk factors such as age, cigarette use, levels of systolic and diastolic blood pressure, fasting glucose, high- and low-density cholesterol, and triglycerides.

Among the 1954 women included in the study, 835 had minimal VMS, 521 had increasing VMS, and 598 had persistent VMS. Among them, there were 81 incident CVD events including 42 strokes.

The findings

Results showed that women with histories of migraine and persistent VMS had a risk of CVD 2 times greater than those without migraine history and with minimal/increasing VMS. After researchers adjusted for CVD risk factors, however, they noted these associations were attenuated (HR 1.51; 95% CI, 0.73-3.10).

Also, women with both migraine and persistent VMS faced a more than 3-fold greater risk of stroke (HR 3.15; 95% CI, 1.35-7.34), which was also attenuated after adjustment for CVD risk factors (HR 1.70; 95% CI, 0.66-4.38).

Authors' comment

"Migraines and persistent VMS jointly associate with greater risk for CVD and stroke, although risk is attenuated with adjustment for traditional CVD risk factors."

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