Migraine with Aura, Associated with Heart Attacks, Strokes and Blood Clots

Two studies will be presented at the annual meeting of the American Academy of Neurology in San Diego during the third week of March.

The first study was done in France and looked at the risk factors for heart attacks and stroke in women.  There have been many studies over the past three decades that have looked at this issue with mixed findings, but most did suggest some level of association between migraine with aura and heart disease or strokes.

This study was important for a couple of reasons. First, it was a very large group of women (27,860) out of which 1,435 had migraine with aura.  The second reason that it was important was that it covered 15 years, a significantly long period for any study.  In the interviews with the researchers they used the term “contributors” as the relationship between migraine with aura and the heart attacks and strokes and it ranked migraine with aura second only to hypertension and above smoking and obesity.

I think there was a point lost in translation because no one, at this juncture, can say that the aura “contributes” to the heart attacks or strokes as no one knows how the two are related. So rather than cause and effect they may be two limbs of the same tree. But migraine with aura may be the second greatest predictor of heart attack or strokes and that is the take home message.

So what does this mean?  First of all, if you don’t have migraine with aura, I wouldn’t loose any sleep over this study.  If you do, then you would take this an opportunity to prevent these bad diseases later in life.  The way you do it is 1) keep your blood pressure under control, 2) prevent your migraines from coming and that could mean daily migraines prevention medications and 3) eliminate other risk factors such as smoking, obesity, and sedimentary lifestyle.  There are no studies so far to suggest that taking a low dose aspirin once a day prevents stroke or heart disease in these patients, but if were me, I think I would. Of course daily aspirin can cause stomach problems so be careful.

The second study was even larger, involving 145,304 women who were on birth control pills. It was found that 7.6% of those who had migraine with aura had blood clots while 6.3 % of those women who had migraines without auras had clots.  They didn’t publish the percentage (so far) of how many women had clots in the study who didn’t have migraine at all.

No know what this relationship is all about.  We do know that it isn’t constricting blood vessels because that has been proven not to be the cause of migraine aura.  It is very complicated but platelets (the part of the blood that starts clots) are more “sticky” during migraine aura.  For more details go here.