Migraine and risk of cardiovascular disease in women
Migraine and risk of cardiovascular disease in women
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DOI：
10.1001/jama.296.3.283
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发表时间：
2006-07-19
影响因子：
120.7
通讯作者：
Buring, Julie E.
中科院分区：
文献类型：
--
作者：
Kurth, Tobias;Gaziano, J. Michael;Buring, Julie E.
背景先兆偏头痛与不利的心血管风险和血栓形成因素有关，这些因素与偏头痛特有的生理因素一起，可能会增加血管事件的风险。虽然有先兆的偏头痛与缺血性中风的风险增加有关，但与心血管疾病(CVD)，特别是冠状动脉事件的相关性仍不清楚。目的评估有或没有先兆的偏头痛与随后总体和特定的CVD风险之间的关系。设计、设置和参与者参加前瞻性队列研究的27 840名年龄在45岁或以上的美国女性，在研究开始时(1992-1995年)没有心血管疾病和心绞痛，并有关于自我报告的偏头痛和先兆状态的信息，以及血脂测量。本报告基于截至2004年3月31日的随访数据。主要结果指标主要指标是主要心血管疾病(第一例非致命性缺血性卒中、非致命性心肌梗死或因缺血性CVD死亡)的综合终点；其他指标为首次缺血性卒中、心肌梗死、冠状动脉血运重建、心绞痛和因缺血性心血管疾病死亡。结果基线时，5125名女性(18.4%)报告有偏头痛病史；在3610名活动期偏头痛(前一年偏头痛)中，1434名(39.7%)有先兆症状。在平均10年的随访期内，共发生了580例重大心血管事件。与无偏头痛病史的妇女相比，有先兆的活动期偏头痛妇女的多变量调整风险比为2.15(95%可信区间，1.58-2.92；P
Context Migraine with aura has been associated with an adverse cardiovascular risk profile and prothrombotic factors that, along with migraine-specific physiology, may increase the risk of vascular events. Although migraine with aura has been associated with increased risk of ischemic stroke, an association with cardiovascular disease (CVD) and, specifically, coronary events remains unclear.Objective To evaluate the association between migraine with and without aura and subsequent risk of overall and specific CVD.Design, Setting, and Participants Prospective cohort study of 27 840 US women aged 45 years or older who were participating in the Women's Health Study, were free of CVD and angina at study entry (1992-1995), and who had information on self-reported migraine and aura status, and lipid measurements. This report is based on follow-up data through March 31, 2004.Main Outcome Measures The primary outcome measure was the combined end point of major CVD (first instance of nonfatal ischemic stroke, nonfatal myocardial infarction, or death due to ischemic CVD); other measures were first ischemic stroke, myocardial infarction, coronary revascularization, angina, and death due to ischemic CVD.Results At baseline, 5125 women (18.4%) reported any history of migraine; of the 3610 with active migraine (migraine in the prior year), 1434 (39.7%) indicated aura symptoms. During a mean of 10 years of follow-up, 580 major CVD events occurred. Compared with women with no migraine history, women who reported active migraine with aura had multivariable-adjusted hazard ratios of 2.15 (95% confidence interval [CI], 1.58-2.92; P