Study Shows Migraine Can Increase Risk of Stroke in Older Smokers

New research led by the University of Miami Miller School of Medicine suggests older people who experience migraines may have an increased risk of stroke, but only if they are smokers. The study, “Migraine and risk of stroke in older adults: Northern Manhattan Study,” led by Teshamae Monteith, M.D., assistant professor of neurology, is published in the online issue of Neurology, the medical journal of the American Academy of Neurology.

“Our findings may provide more evidence as to why quitting smoking is important for people who experience migraine,” said Monteith, who is also Chief of the Headache Division at UHealth – University of Miami Health System and a member of the American Academy of Neurology. “While this investigation of migraine and vascular events in older people found that only smokers with migraine have an increased risk of stroke, earlier studies have shown that women younger than 45 who have migraine with aura are also at an increased risk of stroke, whether or not they smoke.”

For the study, 1,292 people from the Northern Manhattan Study with an average age of 68 who reported migraine were followed for an average of 11 years to see who developed heart attacks or stroke. Of those, 187 had migraine without aura and 75 had migraine with aura. During the study, a total of 294 strokes, heart attacks and deaths occurred.

The study did not find an association between migraine with or without aura and the risk of either stroke or heart attacks. However, among smokers, migraine was associated with a three-fold increased risk of stroke, whereas among nonsmokers, migraine was not associated with a stroke risk.

“Statistically, we could not rule out the possibility that the relationship between migraine and stroke in smokers was due to chance, however, we believe the association is consistent with other studies,” Monteith said.

The collaborative study of investigators from the University of Miami and Columbia University was supported by the National Institute of Neurological Disorders and Stroke. Co-authors from the Miller School are Hannah Gardener, Sc.D., epidemiologist in the Department of Neurology; Tatjana Rundek, M.D., Ph.D., professor of neurology; and Ralph L. Sacco, M.D., M.S., Professor and Chair of Neurology and Olemberg Family Chair in Neurological Disorders.

In May 2014, Monteith led a study published in the American Heart Association journal Stroke, which found that older people with a history of migraines had double the odds of experiencing an ischemic silent brain infarction when compared with people who said they did not have migraines.

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