Migraines and Myocardial Infarction in Women

Abstract

Background: Heart disease is the number 1 cause of death for U.S. women, myocardial infarction (MI) included. It has been established that ischemic stroke has a positive correlation with those who experience migraines, but there were no definitive studies saying that migraines cause all other cardiovascular related diseases, even though there is a common consensus that migraines are a vascular phenomenon. This systematic review focuses on the correlation between migraines and myocardial infarction particularly in women. Methods: An exhaustive search of available medical literature was conducted using MEDLINE-Ovid, Web of Science, and CINAHL databases. The following terms were searched as keywords: migraine, myocardial infarction, and women or female. Studies applicable to the topic of the association of migraines and myocardial infarction in women were included as long as they were in English, on human subjects, and prospective cohort studies. The quality of relevant articles was evaluated via the GRADE Working Group guidelines. Results: The initial search yielded 193 articles that were narrowed down to 3 prospective cohort studies by applying the eligibility criteria. Each study yielded odds ratios of having a MI in women with migraines compared to women without migraines. The Kurth et al, WHS, resulted in the hazard ratios of 1.94 (95% CI 1.27 to 2.95, P value 0.002) for active migraine with aura. The Kurth et al, NHS II, had an age adjusted hazard ratio of 1.79 (95% CI 1.52 to 2.10, P value Conclusion: Women who have migraines, especially those with aura, are at an increased risk of myocardial infarction compared to those without migraines. Providers should consider migraines in women as a positive risk factor for myocardial infarction. These findings should prompt research on the biological process of migraines and whether the treatments we use now can protect women from the increased risk. Keywords: Migraine, myocardial infarction, heart attack, women, female, and risk