Abstract
Objective Migraine has been identified as a potential risk-factor for hypertension in prospective studies. In women, migraine prevalence decreases after menopause, but no studies have determined if migraine is associated with hypertension after menopause. This study sought to determine if history of migraine was associated with an increased risk of hypertension among menopausal women.
Methods We assessed associations between migraine and hypertension in a longitudinal cohort study of 56,202 menopausal women participating in the French E3N cohort, with follow-up beginning in 1993. We included women who did not have hypertension or cardiovascular disease at the age of their menopause. Migraine was classified as ever or never at each questionnaire cycle. Cox proportional hazards models were used to investigate relations between migraine and hypertension, controlling for potential confounding. A secondary analysis with baseline in 2011 considered aura status, grouping participants reporting migraine as migraine with aura, migraine without aura, or unknown migraine type.
Results During 826,419 person years, 12,501 cases of incident hypertension were identified, including 3100 among women with migraine, and 9401 among women without migraine. Migraine was associated with an increased risk of hypertension in menopausal women (HR migraine = 1.29 [1.24: 1.35]), and were consistent in post-hoc sensitivity analyses, such as when controlling for common migraine medications. Associations between migraine and hypertension were similar whether or not women reported aura (HR migraine aura = 1.54 [1.04: 2.30], HR migraine no aura = 1.32 [0.87: 2.02], p-heterogeneity = 0.60). Associations were slightly stronger among ever users of menopausal hormone therapy (HR migraine = 1.34 [1.27: 1.41]), than among never users (HR migraine = 1.19 [1.11: 1.28]).
Conclusion Migraine was associated with an increased risk of hypertension amongst menopausal women. In secondary analysis, we didn’t observe a significant difference between migraine with aura and migraine without aura.
- Received November 17, 2020.
- Accepted in final form March 19, 2021.
- © 2021 American Academy of Neurology
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- Author Response: Association of Migraine With Incident Hypertension After Menopause: A Longitudinal Cohort Study
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