Top

The Journal of Headache and Pain

Published in:

Open Access 01-12-2013 | Research article

Cardiovascular disease risk in women with migraine

Authors: Fernanda Camboim Rockett, Alexandre da Silveira Perla, Ingrid D Schweigert Perry, Márcia L Fagundes Chaves

Published in: The Journal of Headache and Pain | Issue 1/2013

Abstract

Background

Studies suggest a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting. The aim of this study was to investigate traditional and newly recognized risk factors as well as other surrogate markers of cardiovascular risk in obese and normal weight women with migraine.

Methods

Fifty-nine adult female probands participated in this case–control study. The sample was divided into normal weight and obese migraineurs and age- and body mass index-matched control groups. The following cardiovascular risk factors were analyzed: serum levels of lipids, fasting glucose, and insulin; insulin resistance; blood pressure; smoking (categorized as current, past or never); Framingham 10-year risk of general cardiovascular disease score; C-reactive protein; family history of cardiovascular disease; physical activity; sleep disturbances; depression; and bioelectrical impedance phase angle. The means of continuous variables were compared using Student’s t- test for independent samples or the Mann–Whitney U- test (for 2 groups) and ANOVA or the Kruskal-Wallis test (for 4 groups) depending on the distribution of data.

Results

All migraineurs were sedentary irrespective of nutritional status. Migraineurs had higher depression scores and shorter sleep duration, and obese migraineurs, in particular, had worse sleep quality scores. Insulin resistance and insulinaemia were associated with obesity, and obese migraineurs had lower HDL-c than normal weight controls and migraineurs. Also, the Framingham risk score was higher in obese migraineurs.

Conclusion

These findings suggest that female migraineurs experience marked inactivity, depression, and some sleep disturbance, that higher insulin resistance and insulinaemia are related to obesity, and that obesity and migraine probably exert overlapping effects on HDL-c levels and Framingham 10-year cardiovascular risk.

Buse DC, Loder EW, Gorman JA, Stewart WF, Reed ML, Fanning KM, Serrano D, Lipton RB: Sex Differences in the Prevalence, Symptoms, and Associated Features of Migraine, Probable Migraine and Other Severe Headache: Results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache 2013. doi:10.1111/head.12150

Casucci G, Villani V, Cologno D, D’Onofrio F: Migraine and metabolism. Neurol Sci 2012,33(Suppl 1):S81–5.PubMedCrossRef

Ikeda K, Kawase Y, Takazawa T, Kano O, Tamura M, Iwasaki Y: Cardiovascular Disease Risk Profile in Japanese Midlife Migraineurs. J Neurol Res 2012,2(1):10–15.

Lipton RB, Bigal ME: The epidemiology of migraine. Am J Med 2005,118(Suppl 1):3S-10S.PubMed

IHS. INTERNATIONAL HEADACHE SOCIETY: The International Classification of Headache Disorders. Cephalalgia 2004,24(1):1–160. 10.1111/j.1468-2982.2004.00711.xCrossRef

Rist PM, Tzourio C, Kurth T: Associations between lipid levels and migraine: cross-sectional analysis in the epidemiology of vascular ageing study. Cephalalgia 2011,31(14):1459–65. 10.1177/0333102411421682PubMedCentralPubMedCrossRef

Kurth T, Schurks M, Logroscino G, Gaziano JM, Buring JE: Migraine, vascular risk, and cardiovascular events in women: prospective cohort study. Br Med J 2008, 337: a636. 10.1136/bmj.a636CrossRef

Diener HC, Küper M, Kurth T: Migraine-associated risks and comorbidity. J Neurol 2008,255(9):1290–301. 10.1007/s00415-008-0984-6PubMedCrossRef

Scher AI, Terwindt GM, Picavet HS, Verschuren WM, Ferrari MD, Launer LJ: Risk factors and migraine: the GEM population-based study. Neurology 2005,64(4):614–620. 10.1212/01.WNL.0000151857.43225.49PubMedCrossRef

10.

Benseñor IM, Goulart AC, Lotufo PA, Menezes PR, Scazufca M: Cardiovascular risk factors associated with migraine among the elderly with a low income: the Sao Paulo Ageing & Health Study (SPAH). Cephalalgia 2011,31(3):331–7. 10.1177/0333102410380754PubMedCrossRef

11.

Queiroz LP, Peres MF, Piovesan EJ, Kowacs F, Ciciarelli MC, Souza JA, Zukerman E: A nationwide population-based study of migraine in Brazil. Cephalalgia 2009,29(6):642–9. 10.1111/j.1468-2982.2008.01782.xPubMedCrossRef

12.

Gruber HJ, Bernecker C, Pailer S, Lechner A, Horejsi R, Möller R, Fazekas F, Truschnig-Wilders M: Lipid profile in normal weight migraineurs - evidence for cardiovascular risk. Eur J Neurol 2010,17(3):419–25. 10.1111/j.1468-1331.2009.02861.xPubMedCrossRef

13.

Kaptoge S, Di Angelantonio E, Pennells L, Wood AM, White IR, Gao P, Walker M, Thompson A, Sarwar N, Caslake M, Butterworth AS, Amouyel P, Assmann G, Bakker SJ, Barr EL, Barrett-Connor E, Benjamin EJ, Björkelund C, Brenner H, Brunner E, Clarke R, Cooper JA, Cremer P, Cushman M, Dagenais GR, D’Agostino RB Sr, Dankner R, Davey-Smith G, Deeg D, Dekker JM, Emerging Risk Factors Collaboration, et al.: C-reactive protein, fibrinogen, and cardiovascular disease prediction. N Engl J Med 2012,367(14)):1310–1320.PubMed

14.

De Luis DA, Aller R, Romero E, Dueñas A, Perez Castrillon JL: Relation of phase angle tertiles with blood adipocytokines levels, insulin resistance and cardiovascular risk factors in obese women patients. Eur Rev Med Pharmacol Sci 2010,14(6):521–6.PubMed

15.

Whang W, Kubzansky LD, Kawachi I, Rexrode KM, Kroenke CH, Glynn RJ, Garan H, Albert CM: Depression and risk of sudden cardiac death and coronary heart disease in women: results from the Nurses’ Health Study. J Am Coll Cardiol 2009,53(11):950–958. 10.1016/j.jacc.2008.10.060PubMedCentralPubMedCrossRef

16.

Narang I, Manlhiot C, Davies-Shaw J, Gibson D, Chahal N, Stearne K, Fisher A, Dobbin S, McCrindle BW: Sleep disturbance and cardiovascular risk in adolescents. CMAJ 2012,184(17):E913–920.PubMedCentralPubMedCrossRef

17.

ABEP - Associação Brasileira de Empresas de Pesquisa. Critério de Classificação Econômica Brasil [document on the Internet]. 2011. Available from: http://www.abep.org

18.

Stewart WF, Lipton RB, Whyte J, Dowson A, Kolodner K, Liberman JN, Sawyer J: An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score. Neurology 1999, 53: 988–994. 10.1212/WNL.53.5.988PubMedCrossRef

19.

WORLD HEALTH ORGANIZATION: Obesity: Preventing and managing the global epidemic - Report of a WHO consultation on obesity. Geneva: WHO; 1998.

20.

WORLD HEALTH ORGANIZATION: Waist Circumference and Waist-Hip Ratio: Report of WHO Expert Consultation. Geneva: WHO; 2008.

21.

Kyle UG, Bosaeus I, Lorenzo AD, Deurenberg P, Elia M, Gómez JM, Heitmann BL, Kent-Smith L, Melchior JC, Pirlich M, Scharfetter H, Schols AM, Pichard C, Composition of the ESPEN Working Group: Bioelectrical impedance analysis--part I: review of principles and methods. Clin Nutr 2004,23(5):1226–1243. 10.1016/j.clnu.2004.06.004PubMedCrossRef

22.

Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Manuel Gómez J, Lilienthal Heitmann B, Kent-Smith L, Melchior JC, Pirlich M, Scharfetter H, MWJ Schols A, Pichard C, ESPEN: Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr 2004,23(6):1430–1453. 10.1016/j.clnu.2004.09.012PubMedCrossRef

23.

Friedewald WT, Levy RI, Fredrickson DS: Estimation of the Concentration of Low-density Lipoprotein Cholesterol in Plasma, Without Use of the Preparative Ultracentrifuge. Clin Chem 1972,18(6):499–502.PubMed

24.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ: Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee (2003) Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003,42(6):1206–1252. 10.1161/01.HYP.0000107251.49515.c2PubMedCrossRef

25.

D’Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB: General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 2008,117(6):743–753. 10.1161/CIRCULATIONAHA.107.699579PubMedCrossRef

26.

Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, Braggion G: Questionário Internacional de Atividade Física (IPAQ): estudo de validade e reprodutibilidade no Brasil. Rev Bras Ativ Fís Saúde 2001,6(2):5–12.

27.

Beck AT, Steer RA, et al.: Beck Depression Inventory (BDI). In Handbook of Psychiatric Measures. Edited by: Rush AJ, Pincus HA, First MB. Waschington, DC: American Psychiatric Association Press; 2000:519–523.

28.

Gorenstein C, Andrade LH: Inventário de Depressão de Beck: propriedades psicométricas da versão em português. Rev Psiq Clín 1998, 25: 245–250.

29.

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ: The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989, 28: 193–213. 10.1016/0165-1781(89)90047-4PubMedCrossRef

30.

Cappuccio FP, Cooper D, D’Elia L, Strazzullo P, Miller MA: Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J 2011,32(12):1484–92. 10.1093/eurheartj/ehr007PubMedCrossRef

31.

Colín-Ramírez E, Castillo-Martínez L, Orea-Tejeda A, Vázquez-Durán M, Rodríguez AE, Keirns-Davis C: Bioelectrical impedance phase angle as a prognostic marker in chronic heart failure. Nutrition 2012,28(9):901–5. 10.1016/j.nut.2011.11.033PubMedCrossRef

32.

Bigal ME, Kurth T, Santanello N, Buse D, Golden W, Robbins M, Lipton RB: Migraine and cardiovascular disease: a population-based study. Neurology 2010,74(8):628–635. 10.1212/WNL.0b013e3181d0cc8bPubMedCentralPubMedCrossRef

33.

Winsvold BS, Hagen K, Aamodt AH, Stovner LJ, Holmen J, Zwart JA: Headache, migraine and cardiovascular risk factors: the HUNT study. Eur J Neurol 2011,18(3):504–11. 10.1111/j.1468-1331.2010.03199.xPubMedCrossRef

34.

Stam AH, Weller CM, Janssens AC, Aulchenko YS, Oostra BA, Frants RR, van den Maagdenberg AM, Ferrari MD, van Duijn CM, Gisela MT: Migraine is not associated with enhanced atherosclerosis. Cephalalgia 2013,33(4):228–235. 10.1177/0333102412466966PubMedCrossRef

35.

Mora S, Cook N, Buring JE, Ridker PM, Lee IM: Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation 2007,116(19):2110–2118. 10.1161/CIRCULATIONAHA.107.729939PubMedCentralPubMedCrossRef

36.

Kelman L: The triggers or precipitants of the acute migraine attack. Cephalalgia 2007,27(5):394–402. 10.1111/j.1468-2982.2007.01303.xPubMedCrossRef

37.

Varkey E, Hagen K, Zwart JA, Linde M: Physical activity and headache: results from the Nord-Trøndelag Health Study (HUNT). Cephalalgia 2008,28(12):1292–7. 10.1111/j.1468-2982.2008.01678.xPubMedCrossRef

38.

Kurth T, Slomke MA, Kase CS, Cook NR, Lee IM, Gaziano JM, Diener HC, Buring JE: Migraine, headache, and the risk of stroke in women: a prospective study. Neurology 2005,64(6):1020–1026. 10.1212/01.WNL.0000154528.21485.3APubMedCrossRef

39.

MacClellan LR, Giles W, Cole J, Wozniak M, Stern B, Mitchell BD, Kittner SJ: Probable migraine with visual aura and risk of ischemic stroke: the stroke prevention in young women study. Stroke 2007,38(9):2438–45. 10.1161/STROKEAHA.107.488395PubMedCrossRef

40.

Selberg O, Selberg D: Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 2002,86(6):509–16. 10.1007/s00421-001-0570-4PubMedCrossRef

41.

Di Napoli M, Schwaninger M, Cappelli R, Ceccarelli E, Di Gianfilippo G, Donati C, Emsley HC, Forconi S, Hopkins SJ, Masotti L, Muir KW, Paciucci A, Papa F, Roncacci S, Sander D, Sander K, Smith CJ, Stefanini A, Weber D: Evaluation of C-reactive protein measurement for assessing the risk and prognosis in ischemic stroke: a statement for health care professionals from the CRP Pooling Project members. Stroke 2005,36(6):1316–29. 10.1161/01.STR.0000165929.78756.edPubMedCrossRef

42.

Welch KM, Brandes AW, Salerno L, Brandes JL: C-reactive protein may be increased in migraine patients who present with complex clinical features. Headache 2006,46(2):197–9. 10.1111/j.1526-4610.2006.00330.xPubMedCrossRef

43.

Vanmolkot FH, de Hoon JN: Increased C-reactive protein in young adult patients with migraine. Cephalalgia 2007,27(7):843–6. 10.1111/j.1468-2982.2007.01324.xPubMedCrossRef

44.

Bond DS, Roth J, Nash JM, Wing RR: Migraine and obesity: epidemiology, possible mechanisms and the potential role of weight loss treatment. Obes Rev 2010,12(5):e362–71.CrossRef

45.

Frasure-Smith N, Lespérance F: Depression and coronary artery disease. Herz 2006,31(Suppl 3):64–8.PubMed

46.

Péquignot R, Tzourio C, Péres K, Ancellin ML, Perier MC, Ducimetière P, Empana JP: Depressive symptoms, antidepressants and disability and future coronary heart disease and stroke events in older adults: the Three City Study. Eur J Epidemiol 2013,28(3):249–56. 10.1007/s10654-013-9765-3PubMedCrossRef

47.

Wang SJ, Chen PK, Fuh JL: Comorbidities of migraine. Front Neurol 2010,23(1):16.

48.

Moon JS, Smith JH, Lahr BD, Cutrer FM: Longitudinal Associations of Migraine and Depressive Symptoms: A Cohort Analysis. Psychosomatics 2013,54(4):317–327. 10.1016/j.psym.2012.10.010PubMedCrossRef

49.

Vieira RV, Vieira DC, Gomes WB, Gauer G: Alexithymia and its impact on quality of life in a group of Brazilian women with migraine without aura. J Headache Pain 2013,14(1):18. 10.1186/1129-2377-14-18PubMedCentralPubMedCrossRef

50.

Modgill G, Jette N, Wang JL, Becker WJ, Patten SB: A population-based longitudinal community study of major depression and migraine. Headache 2012,52(3):422–32. 10.1111/j.1526-4610.2011.02036.xPubMedCrossRef

51.

Karthik N, Kulkarni GB, Taly AB, Rao S, Sinha S: Sleep disturbances in ‘migraine without aura’--a questionnaire based study. J Neurol Sci 2012,321(1–2):73–76.PubMedCrossRef

52.

Vgontzas A, Cui L, Merikangas KR: Are sleep difficulties associated with migraine attributable to anxiety and depression? Headache 2008,48(10):1451–9. 10.1111/j.1526-4610.2008.01175.xPubMedCentralPubMedCrossRef

53.

Kelman L, Rains JC: Headache and sleep: examination of sleep patterns and complaints in a large clinical sample of migraineurs. Headache 2005,45(7):904–10. 10.1111/j.1526-4610.2005.05159.xPubMedCrossRef

54.

Rains JC, Poceta JS: Sleep and headache disorders: clinical recommendations for headache management. Headache 2006,46(Suppl 3):S147–8.PubMedCrossRef

55.

Cappuccio FP, Stranges S, Kandala NB, Miller MA, Taggart FM, Kumari M, Ferrie JE, Shipley MJ, Brunner EJ, Marmot MG: Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II Study. Hypertension 2007,50(4):693–700. 10.1161/HYPERTENSIONAHA.107.095471PubMedCentralPubMedCrossRef

56.

Cappuccio FP, D’Elia L, Strazzullo P, Miller MA: Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 2010,33(2):414–20. 10.2337/dc09-1124PubMedCentralPubMedCrossRef

57.

Kaneita Y, Uchiyama M, Yoshiike N, Ohida T: Associations of usual sleep duration with serum lipid and lipoprotein levels. Sleep 2008,31(5):645–52.PubMedCentralPubMed

58.

Kurth T, Gaziano JM, Cook NR, Logroscino G, Diener HC, Buring JE: Migraine and risk of cardiovascular disease in women. JAMA 2006, 296: 283–291. 10.1001/jama.296.3.283PubMedCrossRef

59.

Kurth T, Gaziano JM, Cook NR, Bubes V, Logroscino G, Diener HC, Buring JE: Migraine and risk of cardiovascular disease in men. Arch Intern Med 2007,167(8):795–801. 10.1001/archinte.167.8.795PubMedCrossRef

Title: Cardiovascular disease risk in women with migraine
Authors: Fernanda Camboim Rockett
Alexandre da Silveira Perla
Ingrid D Schweigert Perry
Márcia L Fagundes Chaves
Publication date: 01-12-2013
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 1/2013
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/1129-2377-14-75

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Cardiovascular disease risk in women with migraine

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2013

Lateral inhibition in visual cortex of migraine patients between attacks

Clinical features, anger management and anxiety: a possible correlation in migraine children

No evidence of jugular venous valve insufficiency in patients with migraine – a controlled study

The cross- ethnic variations in the prevalence of headache and other somatic complaints among adolescents in Northern Israel

Epidemiological profiles of patients with chronic migraine and chronic tension-type headache

Holding on to the indispensable medication –A grounded theory on medication use from the perspective of persons with medication overuse headache