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Migraine With Aura May Increase Risk of Heart Attack, Blood Clots in Women

Findings to be presented at AAN meeting in March (Jan. 15)

Women who have migraines with aura (visual disturbances, such as flashing lights) may be more likely to have problems with their heart and blood vessels, and those on newer contraceptives may be at higher risk for blood clots, according to two studies that will be presented at the 65th Annual Meeting of the American Academy of Neurology (AAN) in San Diego, Calif., March 16 to 23, 2013.

The first study showed that migraine with aura is a strong contributor to the development of major cardiovascular events, such as heart attack and stroke. The Women’s Health Study involved 27,860 women, including 1,435 women who had migraine with aura. During the 15-year study, there were 1,030 cases of heart attack, stroke, or death from a cardiovascular cause. The new study examined the relative contribution of various vascular risk factors to these major cardiovascular events.

“After high blood pressure, migraine with aura was the second strongest single contributor to risk of heart attacks and strokes,” said lead author Tobias Kurth, MD, ScD. “It came ahead of diabetes, current smoking, obesity, and a family history of early heart disease.”

Kurth cautioned that while people with migraine with aura have an increased cardiovascular risk, it does not mean that everyone with this disorder will have a heart attack or stroke. He said people with migraine with aura can reduce their risk in the same ways others can, such as by not smoking, keeping blood pressure low and weight down, and exercising.

The second study looked at the occurrence of blood clots in women with migraine who used hormonal contraceptives. The study involved women with migraine with and without aura who were taking both newer contraceptives — such as the contraceptive patch and ring — and older contraceptives. Of the 145,304 women who used contraceptives, 2,691 had migraine with aura, and 3,437 had migraine without aura.

Women who had migraine with aura were more likely to have experienced blood clot complications, such as deep vein thrombosis (DVT), with all types of contraceptives than were women with migraine without aura. For example, 7.6% of women with migraine with aura who used a newer-generation combined hormonal contraceptive experienced DVT compared with 6.3% of women with migraine without aura, but the timing of the two events isn’t clear. The occurrence of blood clot complications was also higher in women with migraine who took contraceptives than in women taking contraceptives who did not have migraine.

“Women who have migraine with aura should be sure to include this information in their medical history and talk to their doctors about the possible higher risks of newer contraceptives, given their condition,” said lead author Shivang Joshi, MD, MPH, RPh.

Sources: AAN; Kurth Abstract; and Joshi Abstract; January 15, 2013.

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