A new study has found that women who have migraines accompanied with an aura are at a greater risk of having a heart attack than those that do not get auras. Another study has found that found that women with migraines who take hormonal contraceptives are at increased risk for thrombotic events (blood clots). Both studies were presented this week at the American Academy of Neurology's 65th Annual Meeting in San Diego.
A migraine aura consists of visual disturbances or other symptoms that often precede a migraine. Approximately 20% of migraine sufferers experience an aura. It has been known for some time that having a migraine with an aura increases the risk of stroke, and there is some evidence it may also be associated with cardiovascular disease. However, the new study confirmed that having migraines with auras increases the risk of a heart attack as well.
The researchers accessed data from the Women’s Health Study, which followed 27,860 women over 15 years. The investigators examined the contribution of various risk factors for cardiovascular events. They found that after hypertension (high blood pressure), migraine with aura was the second strongest single contributor to risk of heart attacks and strokes. The risk of a heart attack for a migraine was higher than that of diabetes, current smoking, obesity, and family history of early heart disease.
The second study found that taking hormonal contraceptives significantly increased the risks of thrombotic events for women who suffered from migraines. The aim of the study was to determine whether newer or older contraceptives increase blood clots and whether migraine with aura increased that risk further. The investigators found that women with migraines with aura and taking any combined hormonal contraceptive may be more likely to have thrombotic events than those without aura and without hormonal contraceptive use. Women who suffered from a migraine and experienced an aura as well as those who took newer generation combined hormonal contraceptives had the greatest risks. Newer contraceptives included drospirenone (i.e., Yaz or Yasmine), the transdermal patch, and the vaginal ring.
The new study contributed to previous research, which found women who used contraceptives containing drospirenone had a higher risk of blood clots than those who use older contraceptives. The researchers could not provide an explanation why having an aura would increase the risk of cardiovascular events. However, they theorized that a “wave of electrical activity,” which may underlie migraines with an aura may impact the heart. They noted that unknown genetic factors may be involved. They noted that women with migraines plus aura can reduce their risk of a cardiovascular event by not smoking, keeping their blood pressure under control, maintaining a healthy weight, and exercising.