Migraine and Risk of Haemorrhagic Stroke in Women: Prospective Cohort Study
Date
2010-8-24
Authors
Kurth, Tobias
Kase, Carlos S.
Schürks, Markus
Tzourio, Christophe
Buring, Julie E.
Version
OA Version
Citation
Kurth, Tobias, Carlos S Kase, Markus Schürks, Christophe Tzourio, Julie E Buring. "Migraine and risk of haemorrhagic stroke in women: prospective cohort study" BMJ: British Medical Journal 341:c3659. (2010)
Abstract
Objectives To examine the association between migraine and migraine aura status with risk of haemorrhagic stroke. Design Prospective cohort study. Setting Women's Health Study, United States. Participants 27860 women aged ≥45 who were free from stroke or other major disease at baseline and had provided information on self reported migraine, aura status, and lipid values. Main outcome measures Time to first haemorrhagic stroke and subtypes of haemorrhagic stroke. Results At baseline, 5130 (18%) women reported any history of migraine; of the 3612 with active migraine (migraine in the previous year), 1435 (40%) described having aura. During a mean of 13.6 years of follow-up, 85 haemorrhagic strokes were confirmed after review of medical records. Compared with women without a history of migraine, there was no increased risk of haemorrhagic stroke in those who reported any history of migraine (adjusted hazard ratio 0.98, 95% confidence interval 0.56 to 1.71, P=0.93). In contrast, risk was increased in women with active migraine with aura (2.25, 1.11 to 4.54, P=0.024). The age adjusted increased risk was stronger for intracerebral haemorrhage (2.78, 1.09 to 7.07, P=0.032) and for fatal events (3.56, 1.23 to 10.31, P=0.02). Four additional haemorrhagic stroke events were attributable to migraine with aura per 10000 women per year. Women who reported active migraine without aura had no increased risk for haemorrhagic stroke. Conclusion Migraine with aura might, in addition to ischaemic events, also be a risk factor for haemorrhagic stroke. The relatively low number of events and attributable risk should caution against definitive conclusions and call for further confirmation of these observations.
Description
License
Copyright Kurth et al 2010 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.