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Migraines May Heighten Risk of Vision Problems

Study finds link among middle-aged people with history of the headaches

TUESDAY, May 15, 2007 (HealthDay News) -- Men and women who reach middle age with a history of migraines and other headaches are more likely to have damage to the retina of the eye than people without such a history, a new study says.

This damage, called retinopathy, can lead to severe vision loss and even blindness.

"The people with a history of migraines were more likely to have retinopathy and that's consistent with other studies linking both migraine and retinal disease with stroke," said study lead author Kathryn Rose, a research assistant professor of epidemiology at the University of North Carolina, Chapel Hill.

Dr. Brian M. Grosberg, director of the Inpatient Headache Program at Montefiore Headache Center in New York City, added: "This provides further evidence to support the hypothesis that neurologic and vascular components may underlie migraine headaches. Recent studies have demonstrated associations between migraine with aura and increased risk of cardiovascular disease and stroke. These data suggest that migraine may either lead to or be associated with vasculopathy (disease of the blood vessels)."

The study is published in the May 15 issue of the journal Neurology.

According to background information in the article, migraine headaches affect about 17 percent of women and 6 percent of men in the United States. The underlying mechanisms of migraines are unclear, although scientists think both blood vessels and nerves are involved.

Migraine headaches can be particularly debilitating and can involve additional, unintended problems. A recent survey commissioned by the National Headache Foundation found that 20 percent of migraine sufferers are taking potentially addictive medications that contain barbiturates or opioids and have not been approved for this use.

Migraines have been strongly associated with an increased risk of stroke, including one study that found a 70 percent higher stroke risk among women who have migraines compared with those who don't.

The research linking migraines with high blood pressure and coronary heart disease has been less clear. Some studies have suggested that the associations between migraines and cardiovascular disease may differ by type of migraine and may be stronger for those migraines accompanied by "aura," or visual disturbances.

Retinopathy has been associated with high blood pressure and can predict stroke and other cardiovascular problems, so, it's not out of the question that retinopathy and migraine might be linked as well.

To explore such an association, Rose and her colleagues looked at the headache history and eye health of 10,902 men and women participating in a study funded by the U.S. National Heart, Blood, and Lung Institute. Participants were both black and white and were aged 51 to 71 while in the study.

People with headaches (22 percent of the sample) were 1.3 to 1.5 times more likely to have retinopathy than those without headaches.

People with migraines or other headaches with aura were 1.38 times more likely to have retinopathy than those without headaches; those with migraine but no aura were 1.49 times more likely to have retinopathy; and those with other headaches were 1.28 times more likely to have the eye disease.

The association between migraines and headaches and retinopathy was even stronger among individuals who did not have a history of diabetes or high blood pressure -- two groups that are more likely to have retinopathy, the study found.

"I don't think you can say that migraine causes vascular disease or that migraine causes retinal disease, but I think that whatever is going on, they share the same underlying physiological mechanism," Rose said.

Although there's no obvious action to take from this study, it should alert physicians and patients to pay attention to the findings.

"Although the design of this study does not allow a cause-and-effect relationship to be determined, it's important for the treating physician to adequately address a patient's risk factors for cardiovascular disease and stroke," Grosberg said.

"Clearly more (research) has to be done," Rose added.

More information

To learn more, visit the National Migraine Association.

SOURCES: Kathryn Rose, research assistant professor of epidemiology, University of North Carolina, Chapel Hill; Brian M. Grosberg, M.D., director, Inpatient Headache Program, Montefiore Headache Center, and assistant professor of neurology, Albert Einstein College of Medicine, New York City; May 15, 2007, Neurology; May 15, 2007, news release, National Headache Foundation
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