Die Studie beschreibt an einer großen Gruppe von US-Bürgern Ergebnisse einer Fragebogen-Befragung. Die Autoren schreiben selbst, dass die klinische Relevanz ihrer Ergebnisse noch geklärt werden muss. Bedenkt man die oft unsinnigen (aus meiner Sicht) Dauertherapien bei Migräne in den USA, wie z.B. Dauerbehandlungen mit gefäßverengenden Medikamenten (DHE) oder Vorbeugung mit Triptanen, können solche Ergebnisse auch Folge der Behandlung sein. Allerdings muss auch berücksichtigt werden, dass Migränepatienten meist jung sind. Herzinfarkt, Schlaganfall und Gefäßerkrankungen sind in diesem Alter noch selten. Schon wenige Patienten in der einen oder anderen Gruppe können daher das Risiko verschieben. Als Konsequenz bleibt: Gesund leben und die Migräne gut behandeln, dann hat man das geringste Risiko.
Hier die Zusammenfassung der Studie:
Bigal ME, Kurth T, Santanello N, Buse D, Golden W, Robbins M, Lipton RB.
Migraine and cardiovascular disease. A population-based study.
Neurology. 2010 Feb 10. [Epub ahead of print]
From Scientific Affairs-Neuroscience (M.E.B.), Department of Outcomes Research
(N.S.), and Epidemiology (W.G.), Merck Research Laboratories, Whitehouse Station,
NJ; Departments of Neurology (M.E.B., D.B., M.R., R.B.L.) and Epidemiology and
Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx, NY;
Division of Preventive Medicine (T.K.), Department of Medicine, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA; and The Montefiore Headache
Center (R.B.L.), Bronx, NY.
OBJECTIVES: Although the relationship between migraine and cardiovascular disease
(CVD) has been studied, several questions remain unanswered. Herein we contrast
the rate of diagnosed CVD as well as of risk factors for CVD in individuals with
migraine with and without aura (MA and MO) and in controls. METHODS: In this
case-control study, migraineurs (n = 6,102) and controls (n = 5,243) were
representative of the adult US population. Headache diagnosis was formally
assigned using a validated mailed questionnaire which also obtained details on
treatment, comorbidities, and other variables. CVD events were obtained based on
self-reported medical diagnosis. Risk factors for CVD and modified Framingham
scores were computed. RESULTS: In unadjusted analyses, migraine overall and MA
were associated with myocardial infarction, stroke, and claudication, and MO was
associated with myocardial infarction and claudication. Migraineurs were more
likely than controls to have a medical diagnosis of diabetes (12.6% vs 9.4%, odds
ratio [OR] 1.4, 95% confidence interval [CI] 1.2-1.6), hypertension (33.1% vs
27.5%, OR 1.4, 95% CI 1.3-1.6), and high cholesterol (32.7% vs 25.6%, OR 1.4, 95%
CI 1.3-1.5). Risk was highest in MA, but remained elevated in MO. Framingham
scores were significantly higher in MO and MA than in controls. After adjustments
(gender, age, disability, treatment, CVD risk factors), migraine remained
significantly associated with myocardial infarction (OR 2.2, 95% CI 1.7-2.8),
stroke (OR 1.5, 95% CI 1.2-2.1), and claudication (OR 2.69, 95% CI 1.98-3.23).
CONCLUSION: Both migraine with and without aura are associated with
cardiovascular disease (CVD) and with risk factors for CVD. However, since our
sample size is large, the clinical relevance of the differences is yet to be
established.
PMID: 20147658 [PubMed – as supplied by publisher]
