德国柏林查尔特大学医学院Tobias Kurth联合美国布列根和妇女医院Julie E. Buring团队分析了先兆偏头痛及其他危险因素与心血管疾病的相关性。2020年6月9日，《美国医学会杂志》发表了这一成果。
Title: Association of Migraine With Aura and Other Risk Factors With Incident Cardiovascular Disease in Women
Author: Tobias Kurth, Pamela M. Rist, Paul M Ridker, Gregory Kotler, Vadim Bubes, Julie E. Buring
Abstract: Importance Migraine with aura is known to increase the risk of cardiovascular disease (CVD). The absolute contribution of migraine with aura to CVD incidence in relation to other CVD risk factors remains unclear.
Objective To estimate the CVD incidence rate for women with migraine with aura relative to women with other major vascular risk factors.
Design, Setting, and Participants Female health professionals in the US (the Women’s Health Study cohort) with lipid measurements and no CVD at baseline (1992-1995) were followed up through December 31, 2018.
Exposures Self-reported migraine with aura compared with migraine without aura or no migraine at baseline.
Main Outcomes and Measures The primary outcome was major CVD (first myocardial infarction, stroke, or CVD death). Generalized modeling procedures were used to calculate multivariable-adjusted incidence rates for major CVD events by risk factor status that included all women in the cohort.
Results The study population included 27858 women (mean [SD] age at baseline,54.7 [7.1] years), among whom 1435 (5.2%) had migraine with aura and 26423 (94.8%) did not (2177 [7.8%] had migraine without aura and 24246 [87.0%] had no migraine in the year prior to baseline). During a mean follow-up of 22.6 years (629353 person-years), 1666 major CVD events occurred. The adjusted incidence rate of major CVD per 1000 person-years was 3.36 (95% CI, 2.72-3.99) for women with migraine with aura vs 2.11 (95% CI, 1.98-2.24) for women with migraine without aura or no migraine (P<.001). The incidence rate for women with migraine with aura was significantly higher than the adjusted incidence rate among women with obesity (2.29 [95% CI, 2.02-2.56]), high triglycerides (2.67 [95% CI, 2.38-2.95]), or low high-density lipoprotein cholesterol (2.63 [95% CI, 2.33-2.94]), but was not significantly different from the rates among those with elevated systolic blood pressure (3.78 [95% CI, 2.76-4.81]), high total cholesterol (2.85 [95% CI, 2.38-3.32]), or family history of myocardial infarction (2.71 [95% CI, 2.38-3.05]). Incidence rates among women with diabetes (5.76 [95% CI, 4.68-6.84]) or who currently smoked (4.29 [95% CI, 3.79-4.79]) were significantly higher than those with migraine with aura. The incremental increase in the incidence rate for migraine with aura ranged from 1.01 additional cases per 1000 person-years when added to obesity to 2.57 additional cases per 1000 person-years when added to diabetes.
Conclusions and Relevance In this study of female health professionals aged at least 45 years, women with migraine with aura had a higher adjusted incidence rate of CVD compared with women with migraine without aura or no migraine. The clinical importance of these findings, and whether they are generalizable beyond this study population, require further research.