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Migraine and cardiovascular disease: systematic review and meta-analysis

BMJ, 2009-10, Vol.339 (7728), p.1015-1015 [Peer Reviewed Journal]

2009 BMJ Publishing Group Ltd ;Copyright BMJ Publishing Group LTD Oct 27, 2009 ;ISSN: 0959-8138 ;ISSN: 0959-8146 ;EISSN: 1468-5833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.b3914 ;PMID: 19861375 ;CODEN: BMJOAE

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Title:
Migraine and cardiovascular disease: systematic review and meta-analysis
Author: Schürks, Markus ; Rist, Pamela M ; Bigal, Marcelo E ; Buring, Julie E ; Lipton, Richard B ; Kurth, Tobias
Subjects: Adolescent ; Adult ; Age Factors ; Aged ; Brain Ischemia - etiology ; Brain Ischemia - mortality ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - mortality ; Case-Control Studies ; Cohort Studies ; Contraception ; Contraceptives, Oral - adverse effects ; Disease risk ; Drugs: Cardiovascular System ; Drugs: Obstetrics and Gynaecology ; Epidemiologic Studies ; Evidence-based medicine ; Female ; Headache (Including Migraine) ; Health Education ; Health Promotion ; Heart attacks ; Humans ; Internet ; Ischaemic Heart Disease ; Male ; Middle Aged ; Migraine ; Migraine Disorders - complications ; Migraine Disorders - mortality ; Migraine with Aura ; Mortality ; Myocardial infarction ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Reproductive Medicine ; Risk Factors ; Sex Factors ; Smoking ; Smoking - adverse effects ; Smoking and Tobacco ; Stroke ; Stroke - etiology ; Stroke - mortality ; Strokes ; Systematic review ; Young Adult
Is Part Of: BMJ, 2009-10, Vol.339 (7728), p.1015-1015
Description: Objective To evaluate the association between migraine and cardiovascular disease, including stroke, myocardial infarction, and death due to cardiovascular disease.Design Systematic review and meta-analysis.Data sources Electronic databases (PubMed, Embase, Cochrane Library) and reference lists of included studies and reviews published until January 2009.Selection criteria Case-control and cohort studies investigating the association between any migraine or specific migraine subtypes and cardiovascular disease.Review methods Two investigators independently assessed eligibility of identified studies in a two step approach. Disagreements were resolved by consensus. Studies were grouped according to a priori categories on migraine and cardiovascular disease.Data extraction Two investigators extracted data. Pooled relative risks and 95% confidence intervals were calculated.Results Studies were heterogeneous for participant characteristics and definition of cardiovascular disease. Nine studies investigated the association between any migraine and ischaemic stroke (pooled relative risk 1.73, 95% confidence interval 1.31 to 2.29). Additional analyses indicated a significantly higher risk among people who had migraine with aura (2.16, 1.53 to 3.03) compared with people who had migraine without aura (1.23, 0.90 to 1.69; meta-regression for aura status P=0.02). Furthermore, results suggested a greater risk among women (2.08, 1.13 to 3.84) compared with men (1.37, 0.89 to 2.11). Age less than 45 years, smoking, and oral contraceptive use further increased the risk. Eight studies investigated the association between migraine and myocardial infarction (1.12, 0.95 to 1.32) and five between migraine and death due to cardiovascular disease (1.03, 0.79 to 1.34). Only one study investigated the association between women who had migraine with aura and myocardial infarction and death due to cardiovascular disease, showing a twofold increased risk.Conclusion Migraine is associated with a twofold increased risk of ischaemic stroke, which is only apparent among people who have migraine with aura. Our results also suggest a higher risk among women and risk was further magnified for people with migraine who were aged less than 45, smokers, and women who used oral contraceptives. We did not find an overall association between any migraine and myocardial infarction or death due to cardiovascular disease. Too few studies are available to reliably evaluate the impact of modifying factors, such as migraine aura, on these associations.
Publisher: England: British Medical Journal Publishing Group
Language: English
Identifier: ISSN: 0959-8138
ISSN: 0959-8146
EISSN: 1468-5833
EISSN: 1756-1833
DOI: 10.1136/bmj.b3914
PMID: 19861375
CODEN: BMJOAE
Source: BMJ Open Access Journals
MEDLINE
Alma/SFX Local Collection
ProQuest Central

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Migraine and cardiovascular disease: systematic review and meta-analysis

2009 BMJ Publishing Group Ltd ;Copyright BMJ Publishing Group LTD Oct 27, 2009 ;ISSN: 0959-8138 ;ISSN: 0959-8146 ;EISSN: 1468-5833 ;EISSN: 1756-1833 ;DOI: 10.1136/bmj.b3914 ;PMID: 19861375 ;CODEN: BMJOAE

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