Gilad Ronit, Boaz Mona, Dabby Ron, Finkelstein Vitali, Rapoport Abraham, Lampl Yair
Department of Neurology, Wolfson Medical Center, Holon.
Geriatr Gerontol Int. 2014 Jan;14(1):220-5. doi: 10.1111/ggi.12061. Epub 2013 May 6.
The association between migraine and cerebrovascular disease is well documented in younger migraine patients, especially those with aura. Prevalence estimates of vascular risk factors among elderly migraine sufferers are lacking. The present study was designed to estimate the prevalence of vascular risk factors in the elderly population with late onset of migraine without aura.
The medical records of 163 patients aged 50 years and older suffering from migraine without aura were assessed for vascular risk factors, including hypertension, elevated serum lipid levels, diabetes mellitus and cardiovascular disease. Prevalence was estimated and compared with age- and sex-matched vascular risk factor estimates for the general population extracted from the 2003-2004 Israeli National Health Interview Survey, and to a group of patients matched by age suffering from migraine with aura.
Among women with migraine without aura, hypertension, hyperlipidemia and diabetes mellitus were significantly less prevalent than among women without migraine without aura. Prevalence estimates for vascular risk factors did not differ by migraine among males. The group of older patients suffering from migraine with aura showed a higher incidence of vascular risk factors in respect to the group of migraine patients without aura.
The findings of the present study might have an important clinical relevance, suggesting another pathophysiological process in respect to patients suffering from migraine with aura, and this evidence might have different therapeutic implications.
偏头痛与脑血管疾病之间的关联在年轻偏头痛患者中已有充分记录,尤其是有先兆的患者。老年偏头痛患者中血管危险因素的患病率估计尚缺乏。本研究旨在估计无先兆偏头痛起病较晚的老年人群中血管危险因素的患病率。
对163例年龄在50岁及以上的无先兆偏头痛患者的病历进行评估,以确定血管危险因素,包括高血压、血脂水平升高、糖尿病和心血管疾病。估计患病率,并与从2003 - 2004年以色列国家健康访谈调查中提取的一般人群的年龄和性别匹配的血管危险因素估计值进行比较,并与一组年龄匹配的有先兆偏头痛患者进行比较。
在无先兆偏头痛女性中,高血压、高脂血症和糖尿病的患病率显著低于无偏头痛的女性。男性中血管危险因素的患病率估计在有无偏头痛之间无差异。有先兆偏头痛老年患者组相对于无先兆偏头痛患者组,血管危险因素的发生率更高。
本研究结果可能具有重要的临床意义,提示有先兆偏头痛患者存在另一种病理生理过程,且这一证据可能具有不同的治疗意义。