Introduction. Migraine is a common primary headache disorder involving about 10-15%
of the whole population. Several epidemiological and prospective studies showed a
link between migraine (especially migraine with aura) and cardio- and cerebrovascular
events.We prospectively analyzed the data of vascular event-free middle-aged patients
with migraine who were referred to our Headache Clinic between 01/2014 and 01/2018.
Framingham 10-year risk were calculated; covariates included in the analysis were
age, total cholesterol, HDL cholesterol, systolic blood pressure, antihypertensive
medication use, current smoking, and diabetes status.Total of 1037 patients were screened
and 221 were selected, 161 were women (mean age 55.5 ± 5.2 years) and 60 were men
(mean age 56 ± 6 years). 25 patients (11.3%) were labelled as having low risk, 162
patients (73.3%) had moderate risk, and 34 patients (15.4%) had high or very high
risk. Blood pressure and lipid targets were reached in 73% and in 49% in the moderate
risk and in 53% and 12% in the high risk/very high risk groups, respectively. Migraine
with aura (MA) was associated significantly higher cardiovascular risk profile compared
with migraine without aura (MO). About one-third of our nondiabetic patients had fasting
blood glucose above the normal levels. 24 patients (mean age 60 ± 4.9 years) were
diabetic. Mean blood pressure was 149/85 Hgmm, mean choleterol was 5.11 mmol/l, and
mean LDL was 2.93 mmol/l in this subgroup, respectively, which do not fall within
the recommended targets.Our article draws attention to the higher cardiovascular risk
profile of middle-aged migraineurs and highlights the deficiency of primary prevention.
Pain physicians must be aware of the cardiovascular aspects of migraine and holistic
approach is required instead of focusing only on pain and pain relief.