Editorials

Migraine with aura and the risk of increased mortality

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c4410 (Published 24 August 2010) Cite this as: BMJ 2010;341:c4410
  1. Klaus Berger, neuroepidemiologist1,
  2. Stefan Evers, neurologist2
  1. 1Institute of Epidemiology and Social Medicine, University of Muenster, Domagkstrasse 3, 48149 Muenster, Germany
  2. 2Department of Neurology, University Hospital Muenster, Albert-Schweitzer-Strasse 33, 48149 Muenster, Germany
  1. bergerk{at}uni-muenster.de

    Any discussion of risks should be tailored to the individual

    Evidence suggests that people who have migraine with aura have increased risks of cardiac and cerebrovascular disease.1 Two linked cohort studies add to this evidence. Gudmundsson and colleagues (doi:10.1136/bmj.c3966) examined whether migraine with aura in mid-life is associated with increased mortality from cardiovascular disease, other causes, and all causes,2 and Kurth and colleagues (doi:10.1136/bmj.c3659) assessed the relation between migraine with aura and haemorrhagic stroke.3

    The first study followed 18 725 men and women for about 25 years.2 Because of the large number of people and the long follow-up the authors were able to analyse specific causes of death. They found that people with migraine with aura had a significantly higher risk of all cause mortality (hazard ratio 1.21, 95% confidence interval 1.12 to 1.30) and mortality from cardiovascular disease (1.27, 1.13 to 1.43), mainly as a result of coronary heart disease (1.28, 1.11 to 1.49) and stroke (1.40, 1.10 to 1.78).

    In the second study, Kurth and colleagues assessed 27 860 women aged over 45 who took part in the US Women’s Health Study.3 They found an increased risk of haemorrhagic stroke in women who had migraine with aura (2.25, 1.11 to 4.54). …

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