Migraine patients at increased risk for ischaemic stroke: BMJ

KOREA: Migraine patients are at increased risk for ischaemic stroke but not hemorrhagic stroke, according to a recent study in the journal BMJ Open.

Many studies have established a link between migraine and stroke, but the causative association remains unclear. Sang-Yeon Lee, Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Jongno-gu, Korea, and colleagues conducted the study to investigate the risks of different types of stroke in patients with migraine.

Given the differences in the natures of haemorrhagic stroke and ischaemic stroke in patients, including risk factors and genetic predispositions, the authors hypothesized that the contributions of migraine to an increased risk of stroke differ according to the stroke type. Thus, stroke types should be analyzed separately. Additionally, stroke is a leading cause of mortality; therefore, validation of the association between migraine and stroke may facilitate treatment and prognosis in these cases.

For the purpose, the researchers conducted a longitudinal follow-up study of patients with migraine (n=41,585) and 1:4 matched control participants (n=166,340) using data from a national cohort between 2002 and 2013.

Also Read: Migraine with aura linked to risk of stroke only after age 50 years

Key findings of the study include:

• Higher rates of ischaemic stroke were observed in the migraine group (2.3% [964/41,585]) than in the control group (2.0% [3294/166 340].


• The adjusted HR for ischaemic stroke was 1.18 (95% CI=1.10 to 1.26) in the migraine group.


• Compared with control subjects, participants who reported migraine with aura and migraine without aura had increased adjusted HRs of 1.44 and 1.15, respectively, for ischaemic stroke, but no increased risk of hemorrhagic stroke.


• In subgroup analysis, a strong association between migraine and ischaemic stroke was observed in young patients, specifically young women.


• The contribution of migraine to the occurrence of ischaemic stroke was also observed in middle-aged women and old women.


• The risk of hemorrhagic stroke did not reach statistical significance in any age group.

Also Read: Migraine patients more vulnerable to stroke

"Based on our large population-based cohort study in South Korea, we found that migraine increased the risk of ischaemic stroke, but not hemorrhagic stroke. The subgroup of patients at the highest risk of developing ischaemic stroke was young women," concluded the authors.