Department of Pediatrics, Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria.
Department of Neurology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria.
BMC Cardiovasc Disord. 2023 Aug 1;23(1):384. doi: 10.1186/s12872-023-03409-2.
Migraine with aura is associated with an increased risk of cardiovascular disease, yet the pathophysiology is unknown. Suggested underlying mechanisms of aura formation point into the direction of an abnormal vasoreactivity that also extends to the extracranial vasculature.
In the Early Vascular Ageing Tyrol study, a community-based non-randomized controlled trial conducted in 45 schools and companies in Tyrol (Austria) and South-Tyrol (Italy) between May 2015 and September 2018 aiming to increase cardiovascular health in adolescents, headache syndromes were classified according to the International Classification of Headache Disorders in a face-to-face interview. Carotid-femoral pulse-wave-velocity was measured by applanation tonometry and carotid intima-media-thickness by high-resolution ultrasound of the distal common carotid arteries. Differences in pulse-wave-velocity and carotid intima-media-thickness in youngsters with migraine with aura were compared respectively to those without headache and with other headaches by multivariable linear regression analysis.
Of the 2102 study participants 1589 were aged 14 to 19 (mean 16.8) years and had complete data. 43 (2.7%) reported migraine with aura and 737 (46.4%) other headaches. Mean pulse-wave-velocity was 6.17 m/s (± 0.85) for migraine with aura, 6.06 m/s (± 0.82) for all other headaches and 6.15 (0.95) m/s for participants without headaches. Carotid intima-media-thickness was 411.3 µm (± 43.5) for migraine with aura, 410.9 µm (± 46.0) for all other headaches and 421.6 µm (± 48.4) for participants without headaches. In multivariable linear regression analysis, we found no differences in carotid-femoral pulse-wave-velocity or carotid intima-media-thickness in young subjects with migraine with aura, all other headaches, or no headaches.
In line with previous large-scale studies in adults, we could not demonstrate relevant associations of migraine with aura with markers of arterial stiffness or subclinical atherosclerosis making early vascular ageing an unlikely pathophysiological link between migraine with aura and cardiovascular diseases.
First registered on ClinicalTrials.gov 29/04/2019 (NCT03929692).
有先兆偏头痛与心血管疾病风险增加相关，但病理生理学尚不清楚。先兆形成的潜在机制表明存在血管反应性异常，这种异常也延伸到颅外血管。
在 2015 年 5 月至 2018 年 9 月期间，在奥地利蒂罗尔州和意大利南蒂罗尔的 45 所学校和公司进行了一项基于社区的非随机对照试验——早期血管衰老蒂罗尔研究，旨在增加青少年的心血管健康。在面对面的访谈中，根据国际头痛疾病分类对头痛综合征进行了分类。通过平板压力测量法测量颈股脉搏波速度，通过远端颈总动脉的高分辨率超声测量颈动脉内膜中层厚度。通过多变量线性回归分析，分别比较有先兆偏头痛和无头痛以及其他头痛的年轻人之间脉搏波速度和颈动脉内膜中层厚度的差异。
在 2102 名研究参与者中，有 1589 名年龄在 14 至 19 岁（平均 16.8 岁），且数据完整。43 人（2.7%）报告有先兆偏头痛，737 人（46.4%）报告有其他头痛。有先兆偏头痛的平均脉搏波速度为 6.17m/s（±0.85），所有其他头痛为 6.06m/s（±0.82），无头痛的参与者为 6.15m/s（±0.95）。有先兆偏头痛的颈动脉内膜中层厚度为 411.3μm（±43.5），所有其他头痛为 410.9μm（±46.0），无头痛的参与者为 421.6μm（±48.4）。多变量线性回归分析显示，有先兆偏头痛、所有其他头痛或无头痛的年轻受试者之间，颈动脉-股动脉脉搏波速度或颈动脉内膜中层厚度无差异。
与之前在成年人中进行的大型研究一致，我们未能证明有先兆偏头痛与动脉僵硬或亚临床动脉粥样硬化的相关标志物之间存在相关关系，这使得早期血管老化不太可能成为有先兆偏头痛与心血管疾病之间的病理生理学联系。
首次于 2019 年 4 月 29 日在 ClinicalTrials.gov 注册（NCT03929692）。
