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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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. The relatively low number of events and attributable risk should caution against definitive conclusions and call for further confirmation of these observations.</description><subject>Age Distribution</subject><subject>Aged</subject><subject>Attention deficit disorder</subject><subject>Cardiovascular disease</subject><subject>Cholesterol</subject><subject>Cholesterol - blood</subject><subject>Classification</subject><subject>Cohort analysis</subject><subject>Cohort studies</subject><subject>Epidemiologic Methods</subject><subject>Epidemiologic Studies</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Headache</subject><subject>Headache (Including Migraine)</subject><subject>Headaches</subject><subject>Health hazards</subject><subject>Health risk assessment</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Intracranial Hemorrhages - blood</subject><subject>Intracranial Hemorrhages - etiology</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Migraine</subject><subject>Migraine with Aura</subject><subject>Migraine with Aura - blood</subject><subject>Migraine with Aura - complications</subject><subject>Population</subject><subject>Questionnaires</subject><subject>Stroke</subject><subject>Stroke - blood</subject><subject>Stroke - etiology</subject><subject>Strokes</subject><subject>Vitamin E</subject><subject>Women</subject><subject>Womens health</subject><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>7QJ</sourceid><recordid>eNqF0k1v1DAQBmALgeiq9MAPAEWAhDik-CP22D0g0QhYRIEDH1fLcby73t3Ei50U-u9xSVkVpMLJh_fxaDwehO4TfEwIE8-bbn1smeDqFpqRSsiSS8ZuoxlWXJWSMHmAjlJaY4wpA6kEv4sOKAYmqJAz9O69X0bje1eYvi2iT5siLIqVcV2IcWWW3hZpiGHjCt8X30Pn-pNiF0PaOTv4c1fYsApxyGZsL-6hOwuzTe7o6jxEX16_-lzPy7OPb97WL8_KhoMcSgBqCa0siKpxjWmNbZm0lQHXtq61Aix1SglrF5goAe2CtNZxYbkhVgHF7BC9mOruxqbLN1w_RLPVu-g7Ey90MF7_mfR-pZfhXFNFQSieCzy9KhDDt9GlQXc-Wbfdmt6FMWlJaaUAMP6vhEoqKSsBWT76S67DGPs8Bw2cEsaxEBk9vgkRRTBUQmH-TwWQXyAlUVk9m5TN35GiW-wHQLC-3AydN0P_2oxsH16f2F7-3oMMHkxgnYYQr-dCUEVyXk65T4P7sc9N3Oj8duD6w9da07o-ZfNPc32a_ZPJX_Zwc18_AXiG2Cw</recordid><startdate>20100824</startdate><enddate>20100824</enddate><creator>Kurth, Tobias</creator><creator>Kase, Carlos S</creator><creator>Schürks, Markus</creator><creator>Tzourio, Christophe</creator><creator>Buring, Julie E</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group Ltd</general><scope>9YT</scope><scope>ACMMV</scope><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7QJ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100824</creationdate><title>Migraine and risk of haemorrhagic stroke in women: prospective cohort study</title><author>Kurth, Tobias ; Kase, Carlos S ; Schürks, Markus ; Tzourio, Christophe ; Buring, Julie E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b578t-772c124c764bebadacd38c4a7eddedc67c2e996ccf01967df1dce56c5a1c97203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Age Distribution</topic><topic>Aged</topic><topic>Attention deficit disorder</topic><topic>Cardiovascular disease</topic><topic>Cholesterol</topic><topic>Cholesterol - blood</topic><topic>Classification</topic><topic>Cohort analysis</topic><topic>Cohort studies</topic><topic>Epidemiologic Methods</topic><topic>Epidemiologic Studies</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Headache</topic><topic>Headache (Including Migraine)</topic><topic>Headaches</topic><topic>Health hazards</topic><topic>Health risk assessment</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Intracranial Hemorrhages - blood</topic><topic>Intracranial Hemorrhages - etiology</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Migraine</topic><topic>Migraine with Aura</topic><topic>Migraine with Aura - blood</topic><topic>Migraine with Aura - complications</topic><topic>Population</topic><topic>Questionnaires</topic><topic>Stroke</topic><topic>Stroke - blood</topic><topic>Stroke - etiology</topic><topic>Strokes</topic><topic>Vitamin E</topic><topic>Women</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kurth, Tobias</creatorcontrib><creatorcontrib>Kase, Carlos S</creatorcontrib><creatorcontrib>Schürks, Markus</creatorcontrib><creatorcontrib>Tzourio, Christophe</creatorcontrib><creatorcontrib>Buring, Julie E</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kurth, Tobias</au><au>Kase, Carlos S</au><au>Schürks, Markus</au><au>Tzourio, Christophe</au><au>Buring, Julie E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Migraine and risk of haemorrhagic stroke in women: prospective cohort study</atitle><jtitle>BMJ</jtitle><addtitle>BMJ</addtitle><date>2010-08-24</date><risdate>2010</risdate><volume>341</volume><issue>7771</issue><spage>492</spage><epage>492</epage><pages>492-492</pages><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><eissn>1468-5833</eissn><eissn>1756-1833</eissn><coden>BMJOAE</coden><abstract>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.</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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