Late-Onset Migraine With Aura Linked to Increased Stroke Risk
But onset before age 50 and migraine without aura not associated with higher risk for stroke
TUESDAY, Feb. 19, 2019 (Pharmacist's Briefing) -- There is an increased stroke risk in late life among patients with late-onset migraine with aura (MA), according to a study published online Jan. 21 in Headache.
X. Michelle Androulakis, M.D., from the University of South Carolina in Columbia, and colleagues used data from the Atherosclerosis Risk in Communities study. The authors identified 447 participants with MA and 1,128 participants with migraines without aura (MO) from among 11,592 participants. Study participants were followed for ischemic stroke incidence for 20 years.
The researchers observed an association between age of MA onset ≥50 years old (average duration, 4.75 years) and ischemic stroke versus the no-headache group (multivariable adjusted hazard ratio, 2.17; 95 percent confidence interval, 1.39 to 3.39; P < 0.001). However, there was no association between MA onset <50 years old (average duration, 28.17 years) and stroke (multivariable adjusted hazard ratio, 1.31; 95 percent confidence interval, 0.86 to 2.02; P = 0.212). Regardless of age of onset, MO was not associated with an increased stroke risk. The absolute risk for stroke was 8.27 percent in MA and 4.25 percent in MO.
"I think clinically this is very meaningful, as many individuals with a long history of migraine are concerned about their stroke risk, especially when they get older and when they have other cardiovascular disease risks," Androulakis said in a statement.