Migraine patients need full check-ups
Excruciating migraine attacks with auras make young women, in particular, more vulnerable to heart attacks and strokes.
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Both women and men can suffer a type of headache know as migraine with aura. The “aura” is usually a visual precursor to the headache itself, starting up to 30 minutes before the onslaught of pain. It can consist of blind spots, flashes of light, a prickling sensation on the skin and even hallucinations.
Patients with this type of migraine are more prone to developing other risk factors for cardiovascular disease, such as obesity and high cholesterol, according to findings documented in a doctoral dissertation by researcher and physician Bendik Winsvold, of the University of Oslo.
Cardiovascular disease is more prevalent among migraine-aura patients aged 20-45 than among the general population.
Women are more likely to suffer these complications than men.
“Migraine with aura often strikes young people who are otherwise healthy. Otherwise they are not normally in a category that is likely to suffer heart attacks and strokes. So it’s crucial that we find the cause of this clear rise in risk among younger migraine aura patients,” says Winsvold.
Among females under the age of 45 and who don’t suffer such migraines, the risk of strokes is small – only six out of 100,000 in this age group.
By comparison, the rate among women in this age group who also suffer migraines with aura is 19 per 100,000, according to Winsvold.
Beyond the age of 45, the risks are less clear, due to other factors for cardiovascular disease.
Several have metabolic syndrome
In addition to visual disturbances, auras prior to headaches can involve other sensory disturbances or dizziness lasting from five minutes to an hour.
Winsvold’s PhD dissertation shows that patients who suffer migraines with auras run a 50 percent higher risk of developing a condition called metabolic syndrome as compared to people who don’t get such migraines.
Metabolic syndrome is a term given to a concentration of risk factors for heart disease. Five factors are involved.
These are a large waistline, high cholesterol levels, raised levels of fats (triglycerides) in the bloodstream, hypertension and insulin resistance. A person with at least three of these criteria can be said to have the syndrome.
Prevention
Winsvold’s special field of medical research entails neurology and genetics. He says the findings are important because the risk factors for metabolic syndrome can be reduced.
“This can be done through changes in lifestyle or medical treatment. People who have migraines with auras can be young and otherwise healthy, but still have several of these risk factors, such as hypertension and unfavourable cholesterol,” he said.
“It is thus essential for doctors to carry out thorough check-ups of patients with this type of migraine,” Winsvold says.
The University of Oslo researcher thinks it’s a good idea to be particularly careful about getting enough exercise and maintaining a healthy diet.
“People with migraines are generally less active than others and also tend to smoke more. But we cannot see that inactivity, smoking or diets are independently direct causes of the increased risk of cardiovascular disease among migraine patients.”
“Nevertheless, the health benefits of eating well and exercising regularly are well established and migraines occur less often among people who live healthily,” says Winsvold.
Genetic causes
Winsvold thinks it is possible that cardiovascular disease and migraines partly share common genetic causes.
“Both conditions could share a common genetic factor, or something physiological could occur along with migraines with aura which triggers these other problems. We can speculate as to whether suffering migraines and being predisposed to getting cardiovascular disease are inherited in tandem,” he says.
“Earlier studies have shown that people who have migraines with auras often have relatives diagnosed at a young age with cardiovascular disease. We want to investigate the roles that genes have in this context,” says Winsvold.
Winsvold has previously conducted a study that linked 12 genes to the development of migraines.
“Most of the genes point toward mechanisms in the brain. Several of them regulate sensitivity to oxidative stress, a biochemical process that disturbs cell functions," he says.
“Oxidative stress is also a major factor for development of cardiovascular disease and could be a mechanism jointly causing both diseases,” he said.
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Read the Norwegian version of this article at forskning.no
Translated by: Glenn Ostling
