Scher A I, Terwindt G M, Picavet H S J, Verschuren W M M, Ferrari M D, Launer L J
Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
Neurology. 2005 Feb 22;64(4):614-20. doi: 10.1212/01.WNL.0000151857.43225.49.
Migraine, particularly with aura, is a risk factor for early-onset ischemic stroke. The underlying mechanisms are unknown, but may in part be due to migraineurs having an increased risk profile for cardiovascular disease. In this study, the authors compare the cardiovascular risk profile of adult migraineurs to that of nonmigraineurs.
Participants (n = 5,755, 48% men, age 20 to 65 years) are from the Genetic Epidemiology of Migraine (GEM) study, a population-based study in the Netherlands. A total of 620 current migraineurs were identified: 31% with aura (MA), 64% without aura (MO), and 5% unclassified. Controls were 5,135 individuals without lifetime migraine. Measured cardiovascular risk factors included blood pressure (BP), serum total and high-density lipoprotein cholesterol (TC, HDL), smoking, oral contraceptive use, and the Framingham risk score for myocardial infarction or coronary heart disease (CHD) death.
Compared to controls, migraineurs were more likely to smoke (OR = 1.43 [1.1 to 1.8]), less likely to consume alcohol (OR = 0.58 [0.5 to 0.7]), and more likely to report a parental history of early myocardial infarction. Migraineurs with aura were more likely to have an unfavorable cholesterol profile (TC > or = 240 mg/dL [OR = 1.43 (0.97 to 2.1)], TC:HDL ratio > 5.0 [OR = 1.64 (1.1 to 2.4)]), have elevated BP (systolic BP > 140 mm Hg or diastolic BP > 90 mm Hg [OR = 1.76 (1.04 to 3.0)]), and report a history of early onset CHD or stroke (OR = 3.96 [1.1 to 14.3]); female migraineurs with aura were more likely to be using oral contraceptives (OR = 2.06 [1.05 to 4.0]). The odds of having an elevated Framingham risk score for CHD were approximately doubled for the migraineurs with aura.
Migraineurs, particularly with aura, have a higher cardiovascular risk profile than individuals without migraine.
偏头痛，尤其是伴有先兆的偏头痛，是早发性缺血性中风的一个危险因素。其潜在机制尚不清楚，但部分原因可能是偏头痛患者患心血管疾病的风险增加。在本研究中，作者比较了成年偏头痛患者与非偏头痛患者的心血管风险状况。
参与者（n = 5755，48%为男性，年龄20至65岁）来自荷兰一项基于人群的偏头痛遗传流行病学（GEM）研究。共识别出620名当前偏头痛患者：31%伴有先兆（MA），64%不伴有先兆（MO），5%未分类。对照组为5135名无终生偏头痛的个体。测量的心血管危险因素包括血压（BP）、血清总胆固醇和高密度脂蛋白胆固醇（TC、HDL）、吸烟、口服避孕药使用情况以及心肌梗死或冠心病（CHD）死亡的弗雷明汉风险评分。
与对照组相比，偏头痛患者吸烟的可能性更大（OR = 1.43 [1.1至1.8]），饮酒的可能性更小（OR = 0.58 [0.5至0.7]），且更有可能报告有早发性心肌梗死的家族史。伴有先兆的偏头痛患者更有可能有不利的胆固醇状况（TC≥240 mg/dL [OR = 1.43（0.97至2.1）]，TC:HDL比值>5.0 [OR = 1.64（1.1至2.4）]），血压升高（收缩压>140 mmHg或舒张压>90 mmHg [OR = 1.76（1.04至3.0）]），并报告有早发性冠心病或中风病史（OR = 3.96 [1.1至14.3]）；伴有先兆的女性偏头痛患者更有可能正在使用口服避孕药（OR = 2.06 [1.05至4.0]）。伴有先兆的偏头痛患者患冠心病的弗雷明汉风险评分升高的几率大约翻倍。
偏头痛患者，尤其是伴有先兆的偏头痛患者，比无偏头痛的个体具有更高的心血管风险状况。
