Faculty of Medicine and Health Technology, Tampere University, 33014, Tampere, Finland.
Department of Public Health, Turku University Hospital, Turku, Finland.
BMC Public Health. 2021 Jun 7;21(1):1088. doi: 10.1186/s12889-021-11006-1.
The aim of our study was to evaluate the risk for comorbid cardio- and cerebrovascular diseases in the working-aged migraine population of Finland.
A total of 1505 cases who reported diagnosed migraine and 3010 controls from a cohort of 11,596 cases in the Finnish Health and Social Support Study were included. The study material was linked with two registers. ICD diagnoses I63 for ischemic stroke (IS), I21 - I22 for acute myocardial infarction (AMI), and G43 for transient ischemic attack (TIA) among study participants were drawn from the national Finnish Care Register for Health Care at the follow-up in 2012. Reimbursed triptan prescriptions were drawn from the national Social Security Institution (SII) data. The self-reported vascular risk factors were hypertension, high cholesterol values, any diabetes, myocardial infarction, stroke, and TIA. Odds Ratios (OR) with 95% confidence (95% CI) intervals were assessed for diagnosed stroke, myocardial infarction, and TIA.
Migraineurs were mostly female (82%) and ≥ 54 years old (62%). Triptans were reimbursed among 34.7% of migraineurs. A self-reported hypertension (21%), high serum cholesterol (38%), and any diabetes (7%) were more common among migraineurs vs controls (p < 0.05). There was no risk for AMI. The risk for TIA (OR 3.20, 95% CI 1.45-7.05) and IS (2.57, 95% CI 1.28-5.17) among migraineurs vs controls remained high after adjustment for self-reported hypertension, obesity, and smoking. The risk was higher among women in two groups ≥54 years (3.25, 95% CI 1.35-7.84 and 5.0, 95% CI 1.94-12.89, respectively). The average age for IS in migraine was 57.5 years and for TIA 58.2 years among women, and 52.8 years and 50.3 years among men, respectively.
Cardiovascular risk should be screened in the aging migraine population, and hormonal and other migraine-related risk factors should be considered, especially among women. Efficacious attack treatment with triptans should be offered to migraine patients who do not show contraindications.
我们的研究旨在评估芬兰工作年龄段偏头痛患者合并心脑血管疾病的风险。
本研究共纳入了 11596 例病例中的 1505 例偏头痛确诊病例和 3010 名对照。研究资料与两个登记处相关联。在 2012 年的随访中，从国家芬兰保健和社会支持研究的全国芬兰保健登记处获得了研究参与者的缺血性中风（IS）ICD 诊断 I63、急性心肌梗死（AMI）I21-I22 和短暂性脑缺血发作（TIA）G43。从国家社会保障机构（SII）的数据中获得了报销的曲坦类药物处方。报告的血管危险因素包括高血压、高胆固醇值、任何糖尿病、心肌梗死、中风和 TIA。使用比值比（OR）和 95%置信区间（95%CI）评估诊断性中风、心肌梗死和 TIA 的风险。
偏头痛患者主要为女性（82%）和≥54 岁（62%）。34.7%的偏头痛患者报销了曲坦类药物。与对照组相比，偏头痛患者更常见报告有高血压（21%）、高血清胆固醇（38%）和任何糖尿病（7%）（p<0.05）。偏头痛患者没有 AMI 的风险。偏头痛患者与对照组相比，TIA 的风险（OR 3.20，95%CI 1.45-7.05）和 IS（2.57，95%CI 1.28-5.17）仍然较高，调整了自我报告的高血压、肥胖和吸烟后。≥54 岁的两组女性中风险更高（3.25，95%CI 1.35-7.84 和 5.0，95%CI 1.94-12.89）。女性偏头痛患者的 IS 平均年龄为 57.5 岁，TIA 为 58.2 岁，男性分别为 52.8 岁和 50.3 岁。
应在老龄化偏头痛人群中筛查心血管风险，并应考虑激素和其他与偏头痛相关的风险因素，尤其是在女性中。对于没有禁忌症的偏头痛患者，应提供有效的发作治疗曲坦类药物。
