Migraine and risk of haemorrhagic stroke in women: prospective cohort study

Objectives To examine the association between migraine and migraine aura status with risk of haemorrhagic stroke. Design Prospective cohort study. Setting Women’s Health Study, United States. Participants 27 860 women aged ≥45 who were free from stroke or other major disease at baseline and had prov...

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Veröffentlicht in:BMJ 2010-08, Vol.341 (7771), p.492-492
Hauptverfasser: Kurth, Tobias, Kase, Carlos S, Schürks, Markus, Tzourio, Christophe, Buring, Julie E
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container_end_page 492
container_issue 7771
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container_title BMJ
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creator Kurth, Tobias
Kase, Carlos S
Schürks, Markus
Tzourio, Christophe
Buring, Julie E
description Objectives To examine the association between migraine and migraine aura status with risk of haemorrhagic stroke. Design Prospective cohort study. Setting Women’s Health Study, United States. Participants 27 860 women aged ≥45 who were free from stroke or other major disease at baseline and had provided information on self reported migraine, aura status, and lipid values. Main outcome measures Time to first haemorrhagic stroke and subtypes of haemorrhagic stroke. Results At baseline, 5130 (18%) women reported any history of migraine; of the 3612 with active migraine (migraine in the previous year), 1435 (40%) described having aura. During a mean of 13.6 years of follow-up, 85 haemorrhagic strokes were confirmed after review of medical records. Compared with women without a history of migraine, there was no increased risk of haemorrhagic stroke in those who reported any history of migraine (adjusted hazard ratio 0.98, 95% confidence interval 0.56 to 1.71, P=0.93). In contrast, risk was increased in women with active migraine with aura (2.25, 1.11 to 4.54, P=0.024). The age adjusted increased risk was stronger for intracerebral haemorrhage (2.78, 1.09 to 7.07, P=0.032) and for fatal events (3.56, 1.23 to 10.31, P=0.02). Four additional haemorrhagic stroke events were attributable to migraine with aura per 10 000 women per year. Women who reported active migraine without aura had no increased risk for haemorrhagic stroke. Conclusion Migraine with aura might, in addition to ischaemic events, also be a risk factor for haemorrhagic stroke. The relatively low number of events and attributable risk should caution against definitive conclusions and call for further confirmation of these observations.
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Design Prospective cohort study. Setting Women’s Health Study, United States. Participants 27 860 women aged ≥45 who were free from stroke or other major disease at baseline and had provided information on self reported migraine, aura status, and lipid values. Main outcome measures Time to first haemorrhagic stroke and subtypes of haemorrhagic stroke. Results At baseline, 5130 (18%) women reported any history of migraine; of the 3612 with active migraine (migraine in the previous year), 1435 (40%) described having aura. During a mean of 13.6 years of follow-up, 85 haemorrhagic strokes were confirmed after review of medical records. Compared with women without a history of migraine, there was no increased risk of haemorrhagic stroke in those who reported any history of migraine (adjusted hazard ratio 0.98, 95% confidence interval 0.56 to 1.71, P=0.93). In contrast, risk was increased in women with active migraine with aura (2.25, 1.11 to 4.54, P=0.024). The age adjusted increased risk was stronger for intracerebral haemorrhage (2.78, 1.09 to 7.07, P=0.032) and for fatal events (3.56, 1.23 to 10.31, P=0.02). Four additional haemorrhagic stroke events were attributable to migraine with aura per 10 000 women per year. Women who reported active migraine without aura had no increased risk for haemorrhagic stroke. Conclusion Migraine with aura might, in addition to ischaemic events, also be a risk factor for haemorrhagic stroke. The relatively low number of events and attributable risk should caution against definitive conclusions and call for further confirmation of these observations.</description><edition>International edition</edition><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 0959-8146</identifier><identifier>ISSN: 0959-535X</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.c3659</identifier><identifier>PMID: 20736268</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Age Distribution ; Aged ; Attention deficit disorder ; Cardiovascular disease ; Cholesterol ; Cholesterol - blood ; Classification ; Cohort analysis ; Cohort studies ; Epidemiologic Methods ; Epidemiologic Studies ; Epidemiology ; Female ; Headache ; Headache (Including Migraine) ; Headaches ; Health hazards ; Health risk assessment ; Hemorrhage ; Humans ; Intracranial Hemorrhages - blood ; Intracranial Hemorrhages - etiology ; Medical records ; Middle Aged ; Migraine ; Migraine with Aura ; Migraine with Aura - blood ; Migraine with Aura - complications ; Population ; Questionnaires ; Stroke ; Stroke - blood ; Stroke - etiology ; Strokes ; Vitamin E ; Women ; Womens health</subject><ispartof>BMJ, 2010-08, Vol.341 (7771), p.492-492</ispartof><rights>Kurth et al 2010</rights><rights>2010 BMJ Publishing Group Ltd</rights><rights>Copyright: 2010 © Kurth et al 2010</rights><rights>Copyright BMJ Publishing Group Sep 4, 2010</rights><rights>Kurth et al 2010 2010 Kurth et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b578t-772c124c764bebadacd38c4a7eddedc67c2e996ccf01967df1dce56c5a1c97203</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/341/bmj.c3659.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmj.com/content/341/bmj.c3659.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>114,115,230,314,780,784,803,885,3196,23571,27924,27925,30999,31000,58017,58250,77600,77631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20736268$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kurth, Tobias</creatorcontrib><creatorcontrib>Kase, Carlos S</creatorcontrib><creatorcontrib>Schürks, Markus</creatorcontrib><creatorcontrib>Tzourio, Christophe</creatorcontrib><creatorcontrib>Buring, Julie E</creatorcontrib><title>Migraine and risk of haemorrhagic stroke in women: prospective cohort study</title><title>BMJ</title><addtitle>BMJ</addtitle><description>Objectives To examine the association between migraine and migraine aura status with risk of haemorrhagic stroke. Design Prospective cohort study. Setting Women’s Health Study, United States. Participants 27 860 women aged ≥45 who were free from stroke or other major disease at baseline and had provided information on self reported migraine, aura status, and lipid values. Main outcome measures Time to first haemorrhagic stroke and subtypes of haemorrhagic stroke. Results At baseline, 5130 (18%) women reported any history of migraine; of the 3612 with active migraine (migraine in the previous year), 1435 (40%) described having aura. During a mean of 13.6 years of follow-up, 85 haemorrhagic strokes were confirmed after review of medical records. Compared with women without a history of migraine, there was no increased risk of haemorrhagic stroke in those who reported any history of migraine (adjusted hazard ratio 0.98, 95% confidence interval 0.56 to 1.71, P=0.93). In contrast, risk was increased in women with active migraine with aura (2.25, 1.11 to 4.54, P=0.024). The age adjusted increased risk was stronger for intracerebral haemorrhage (2.78, 1.09 to 7.07, P=0.032) and for fatal events (3.56, 1.23 to 10.31, P=0.02). Four additional haemorrhagic stroke events were attributable to migraine with aura per 10 000 women per year. Women who reported active migraine without aura had no increased risk for haemorrhagic stroke. Conclusion Migraine with aura might, in addition to ischaemic events, also be a risk factor for haemorrhagic stroke. 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Design Prospective cohort study. Setting Women’s Health Study, United States. Participants 27 860 women aged ≥45 who were free from stroke or other major disease at baseline and had provided information on self reported migraine, aura status, and lipid values. Main outcome measures Time to first haemorrhagic stroke and subtypes of haemorrhagic stroke. Results At baseline, 5130 (18%) women reported any history of migraine; of the 3612 with active migraine (migraine in the previous year), 1435 (40%) described having aura. During a mean of 13.6 years of follow-up, 85 haemorrhagic strokes were confirmed after review of medical records. Compared with women without a history of migraine, there was no increased risk of haemorrhagic stroke in those who reported any history of migraine (adjusted hazard ratio 0.98, 95% confidence interval 0.56 to 1.71, P=0.93). In contrast, risk was increased in women with active migraine with aura (2.25, 1.11 to 4.54, P=0.024). The age adjusted increased risk was stronger for intracerebral haemorrhage (2.78, 1.09 to 7.07, P=0.032) and for fatal events (3.56, 1.23 to 10.31, P=0.02). Four additional haemorrhagic stroke events were attributable to migraine with aura per 10 000 women per year. Women who reported active migraine without aura had no increased risk for haemorrhagic stroke. Conclusion Migraine with aura might, in addition to ischaemic events, also be a risk factor for haemorrhagic stroke. The relatively low number of events and attributable risk should caution against definitive conclusions and call for further confirmation of these observations.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>20736268</pmid><doi>10.1136/bmj.c3659</doi><tpages>1</tpages><edition>International edition</edition><oa>free_for_read</oa></addata></record>
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subjects Age Distribution
Aged
Attention deficit disorder
Cardiovascular disease
Cholesterol
Cholesterol - blood
Classification
Cohort analysis
Cohort studies
Epidemiologic Methods
Epidemiologic Studies
Epidemiology
Female
Headache
Headache (Including Migraine)
Headaches
Health hazards
Health risk assessment
Hemorrhage
Humans
Intracranial Hemorrhages - blood
Intracranial Hemorrhages - etiology
Medical records
Middle Aged
Migraine
Migraine with Aura
Migraine with Aura - blood
Migraine with Aura - complications
Population
Questionnaires
Stroke
Stroke - blood
Stroke - etiology
Strokes
Vitamin E
Women
Womens health
title Migraine and risk of haemorrhagic stroke in women: prospective cohort study
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