Migraine, headache, and the risk of stroke in women - A prospective study
Migraine, headache, and the risk of stroke in women - A prospective study
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DOI：
10.1212/01.wnl.0000154528.21485.3a
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发表时间：
2005-03-22
期刊：
影响因子：
9.9
通讯作者：
Buring, JE
中科院分区：
文献类型：
--
作者：
Kurth, T;Slomke, MA;Buring, JE
背景：偏头痛和头痛通常与随后的卒中风险相关，主要是在回顾性病例对照研究中。评估特定头痛形式与中风之间关系的前瞻性数据很少。方法：对39,754名年龄在45岁及以上的美国卫生专业人员进行前瞻性队列研究，平均随访时间为9年。偶发性中风由患者自我报告并经病历审查证实。结果：共发生卒中385例（缺血性卒中309例，出血性卒中72例，不明原因卒中4例）。与非偏头痛患者相比，报告偏头痛或无先兆偏头痛的参与者没有增加任何类型中风的风险。报告有先兆偏头痛的参与者，总卒中的调整危险比（hr）增加了1.53 (95% CI 1.02至2.31)，缺血性卒中的调整危险比（hr）增加了1.71 (95% CI 1.11至2.66)，但出血性卒中的风险没有增加。伴有先兆偏头痛的受试者年龄< 55岁，总卒中（HR 1.75; 95% CI 1.02 - 3.00）和缺血性卒中（HR 2.25; 95% CI 1.30 - 3.91）的风险增加更大。与没有头痛的参与者相比，一般头痛和非偏头痛与缺血性或出血性中风无关。结论：在这些前瞻性数据中，偏头痛与全卒中、缺血性卒中或出血性卒中无关。在亚组分析中，我们发现先兆偏头痛患者发生全卒中和缺血性卒中的风险增加。然而，绝对风险增加很低，每年每10,000名妇女增加3.8例。
Background: Migraine and headache in general have been associated with subsequent risk of stroke, primarily in retrospective case-control studies. Prospective data evaluating the association between specific headache forms and stroke are sparse. Methods: A prospective cohort study was conducted among 39,754 US health professionals age 45 and older participating in the Women's Health Study with an average follow-up of 9 years. Incident stroke was self-reported and confirmed by medical record review. Results: A total of 385 strokes ( 309 ischemic, 72 hemorrhagic, and 4 undefined) occurred. Compared with nonmigraineurs, participants who reported migraine overall or migraine without aura had no increased risk of any stroke type. Participants who reported migraine with aura had increased adjusted hazards ratios (HRs) of 1.53 ( 95% CI 1.02 to 2.31) for total stroke and 1.71 ( 95% CI 1.11 to 2.66) for ischemic stroke but no increased risk for hemorrhagic stroke. Participants with migraine with aura who were < 55 years old had a greater increase in risk of total (HR 1.75; 95% CI 1.02 to 3.00) and ischemic ( HR 2.25; 95% CI 1.30 to 3.91) stroke. Compared with participants without headache, headache in general and nonmigraine headache were not associated with total, ischemic, or hemorrhagic stroke. Conclusions: In these prospective data, migraine was not associated with total, ischemic, or hemorrhagic stroke. In subgroup analyses, we found increased risks of total and ischemic stroke for migraineurs with aura. The absolute risk increase was, however, low, with 3.8 additional cases per year per 10,000 women.