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October 18, 2022; 99 (16) Research Article

Vascular Risk Score and Associations With Past, Current, or Future Migraine in Women

Cohort Study

Khatera Ibrahimi, View ORCID ProfilePamela M. Rist, View ORCID ProfileClaire Carpenet, View ORCID ProfileJessica L. Rohmann, Julie E. Buring, View ORCID ProfileAntoinette Maassen van den Brink, View ORCID ProfileTobias Kurth
First published August 19, 2022, DOI: https://doi.org/10.1212/WNL.0000000000201009
Khatera Ibrahimi
From the Division of Vascular Medicine and Pharmacology (K.I., A.M.B.), Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands; Division of Preventive Medicine (P.M.R., J.E.B.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology (P.M.R., J.E.B., T.K.), Harvard T.H. Chan School of Public Health, Boston, MA; PLoegh Lab (C.C.), Program in Cellular and Molecular Medicine (PCMM), Boston Children Hospital and Harvard Medical School, MA; Center for Stroke Research (J.L.R.), Charité–Universitätsmedizin Berlin, Germany; and Institute of Public Health (J.L.R., T.K.), Charité–Universitätsmedizin Berlin, Germany.
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Pamela M. Rist
From the Division of Vascular Medicine and Pharmacology (K.I., A.M.B.), Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands; Division of Preventive Medicine (P.M.R., J.E.B.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology (P.M.R., J.E.B., T.K.), Harvard T.H. Chan School of Public Health, Boston, MA; PLoegh Lab (C.C.), Program in Cellular and Molecular Medicine (PCMM), Boston Children Hospital and Harvard Medical School, MA; Center for Stroke Research (J.L.R.), Charité–Universitätsmedizin Berlin, Germany; and Institute of Public Health (J.L.R., T.K.), Charité–Universitätsmedizin Berlin, Germany.
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Claire Carpenet
From the Division of Vascular Medicine and Pharmacology (K.I., A.M.B.), Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands; Division of Preventive Medicine (P.M.R., J.E.B.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology (P.M.R., J.E.B., T.K.), Harvard T.H. Chan School of Public Health, Boston, MA; PLoegh Lab (C.C.), Program in Cellular and Molecular Medicine (PCMM), Boston Children Hospital and Harvard Medical School, MA; Center for Stroke Research (J.L.R.), Charité–Universitätsmedizin Berlin, Germany; and Institute of Public Health (J.L.R., T.K.), Charité–Universitätsmedizin Berlin, Germany.
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Jessica L. Rohmann
From the Division of Vascular Medicine and Pharmacology (K.I., A.M.B.), Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands; Division of Preventive Medicine (P.M.R., J.E.B.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology (P.M.R., J.E.B., T.K.), Harvard T.H. Chan School of Public Health, Boston, MA; PLoegh Lab (C.C.), Program in Cellular and Molecular Medicine (PCMM), Boston Children Hospital and Harvard Medical School, MA; Center for Stroke Research (J.L.R.), Charité–Universitätsmedizin Berlin, Germany; and Institute of Public Health (J.L.R., T.K.), Charité–Universitätsmedizin Berlin, Germany.
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Julie E. Buring
From the Division of Vascular Medicine and Pharmacology (K.I., A.M.B.), Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands; Division of Preventive Medicine (P.M.R., J.E.B.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology (P.M.R., J.E.B., T.K.), Harvard T.H. Chan School of Public Health, Boston, MA; PLoegh Lab (C.C.), Program in Cellular and Molecular Medicine (PCMM), Boston Children Hospital and Harvard Medical School, MA; Center for Stroke Research (J.L.R.), Charité–Universitätsmedizin Berlin, Germany; and Institute of Public Health (J.L.R., T.K.), Charité–Universitätsmedizin Berlin, Germany.
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Antoinette Maassen van den Brink
From the Division of Vascular Medicine and Pharmacology (K.I., A.M.B.), Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands; Division of Preventive Medicine (P.M.R., J.E.B.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology (P.M.R., J.E.B., T.K.), Harvard T.H. Chan School of Public Health, Boston, MA; PLoegh Lab (C.C.), Program in Cellular and Molecular Medicine (PCMM), Boston Children Hospital and Harvard Medical School, MA; Center for Stroke Research (J.L.R.), Charité–Universitätsmedizin Berlin, Germany; and Institute of Public Health (J.L.R., T.K.), Charité–Universitätsmedizin Berlin, Germany.
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Tobias Kurth
From the Division of Vascular Medicine and Pharmacology (K.I., A.M.B.), Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands; Division of Preventive Medicine (P.M.R., J.E.B.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology (P.M.R., J.E.B., T.K.), Harvard T.H. Chan School of Public Health, Boston, MA; PLoegh Lab (C.C.), Program in Cellular and Molecular Medicine (PCMM), Boston Children Hospital and Harvard Medical School, MA; Center for Stroke Research (J.L.R.), Charité–Universitätsmedizin Berlin, Germany; and Institute of Public Health (J.L.R., T.K.), Charité–Universitätsmedizin Berlin, Germany.
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  • ORCID record for Tobias Kurth
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Vascular Risk Score and Associations With Past, Current, or Future Migraine in Women
Cohort Study
Khatera Ibrahimi, Pamela M. Rist, Claire Carpenet, Jessica L. Rohmann, Julie E. Buring, Antoinette Maassen van den Brink, Tobias Kurth
Neurology Oct 2022, 99 (16) e1694-e1701; DOI: 10.1212/WNL.0000000000201009

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Abstract

Background and Objectives Migraine has consistently been associated with an increased risk of cardiovascular disease (CVD) events. It remains, however, unclear to what extent cardiovascular risk profiles might be linked with migraine activity status and how these profiles relate to the development of migraine.

Methods We used data from a cohort study of female health professionals (Women's Health Study, n = 27,539, age ≥45 years at baseline) without a history of CVD or other major diseases and who provided a blood sample at baseline. Framingham risk scores (FRSs) estimating the 10-year risk of coronary heart disease calculated at baseline were used to create vascular risk categories. The presence or development of self-reported migraine was assessed by questionnaires. Women were classified as having no migraine, history of migraine (experienced migraine in the past but did not experience any migraine attacks in the year before enrollment), active migraine at baseline (active), or incident migraine (first report of migraine during follow-up but not at baseline). We used multinomial logistic regression models to calculate ORs for the association between FRS categories and migraine status.

Results Of the 27,539 participants, a total of 21,927 women did not report migraine, 1,500 women reported a history of migraine, 3,579 had migraine at baseline, and 533 reported migraine for the first time during follow-up. The odds of the probability of having a history of migraine at baseline (vs never migraine) was 76% higher among those with FRS ≥10% compared with FRS ≤1% after adjustment (OR = 1.76, 95% CI 1.39–2.23). In contrast, having FRS ≥10% was associated with reduced odds of having active migraine at baseline (OR = 0.64, 95% CI 0.52–0.80) and with newly reported migraine during follow-up (OR = 0.42, 95% CI 0.22–0.81) when compared with women with FRS category ≤1% and those not reporting migraine. A similar association pattern was observed for FRS categories 5%–9% and 2%–4%.

Discussion High FRS categories were only observed among women with a history of migraine but not with active migraine at baseline or incident migraine after baseline. Our results suggest that the life course of migraine should be considered when studying associations with the vascular system. Our data further suggest that a relatively healthy vascular system, as assessed by the FRS, is associated with active migraine status or developing migraine in the future.

Glossary

CVD=
cardiovascular disease;
FRS=
Framingham Risk Score;
CGRP=
calcitonin gene-related peptide

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • ↵* The first 2 authors contributed equally to this work and share the first author position. The last 2 authors equally supervised the work and share the senior author position.

  • Submitted and externally peer reviewed. The handling editor was Rebecca Burch, MD.

  • Editorial, page 681

  • Received January 27, 2022.
  • Accepted in final form June 9, 2022.
  • © 2022 American Academy of Neurology
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Letters: Rapid online correspondence

  • Reader Response: Vascular Risk Score and Associations With Past, Current, or Future Migraine in Women: Cohort Study
    • Qian Feng, Neurological physician, Department of Neurology ,Suzhou Hospital Affiliated to Nanjing Medical University ,Suzhou,China
    • Ruyang Zhang, Neurological physician, Department of Neurology ,Suzhou Wuzhong People's Hospital ,Suzhou,China
    Submitted September 11, 2022
  • Author Response: Vascular Risk Score and Associations With Past, Current, or Future Migraine in Women: Cohort Study
    • Tobias Kurth, Epidemiologist, Institute of Public Health, Charité ​ – Universitätsmedizin Berlin, Berlin, Germany
    • Antoinette Maassen van den Brink, Neurovascular Pharmacologist, Division of Vascular Medicine and Pharmacology, Dept. of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
    Submitted September 01, 2022
  • Reader Response: Vascular Risk Score and Associations With Past, Current, or Future Migraine in Women: Cohort Study
    • Vinod K. Gupta, Physician-Medical Director, GUPTA MEDICAL CENTRE, MIGRAINE-HEADACHE INSTITUTE, S-407, Greater Kailash-Part Two, New Delhi, INDIA-110048
    Submitted August 21, 2022
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