TY - JOUR
T1 - Migraine and cardiovascular disease
T2 - what cardiologists should know
AU - Kalkman, Deborah N.
AU - Couturier, Emile G. M.
AU - el Bouziani, Abdelhak
AU - Dahdal, Jorge
AU - Neefs, Jolien
AU - Woudstra, Janneke
AU - Vogel, Birgit
AU - Trabattoni, Daniela
AU - MaassenVanDenBrink, Antoinette
AU - Mehran, Roxana
AU - de Winter, Robbert J.
AU - Appelman, Yolande
N1 - Publisher Copyright: © 2023 The Author(s).
PY - 2023/8/7
Y1 - 2023/8/7
N2 - Migraine is a chronic neurovascular disease with a complex, not fully understood pathophysiology with multiple causes. People with migraine suffer from recurrent moderate to severe headache attacks varying from 4 to 72 h. The prevalence of migraine is two to three times higher in women compared with men. Importantly, it is the most disabling disease in women <50 years of age due to a high number of years lived with disability, resulting in a very high global socioeconomic burden. Robust evidence exists on the association between migraine with aura and increased incidence of cardiovascular disease (CVD), in particular ischaemic stroke. People with migraine with aura have an increased risk of atrial fibrillation, myocardial infarction, and cardiovascular death compared with those without migraine. Ongoing studies investigate the relation between migraine and angina with non-obstructive coronary arteries and migraine patients with patent foramen ovale. Medication for the treatment of migraine can be preventative medication, such as beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, antiepileptics, antidepressants, some of the long-acting calcitonin gene-related peptide receptor antagonists, or monoclonal antibodies against calcitonin gene-related peptide or its receptor, or acute medication, such as triptans and calcitonin gene-related peptide receptor antagonists. However, these medications might raise concerns when migraine patients also have CVD due to possible (coronary) side effects. Specifically, knowledge gaps remain for the contraindication to newer treatments for migraine. All cardiologists will encounter patients with CVD and migraine. This state-of-the-art review will outline the basic pathophysiology of migraine and the associations between migraine and CVD, discuss current therapies, and propose future directions for research.
AB - Migraine is a chronic neurovascular disease with a complex, not fully understood pathophysiology with multiple causes. People with migraine suffer from recurrent moderate to severe headache attacks varying from 4 to 72 h. The prevalence of migraine is two to three times higher in women compared with men. Importantly, it is the most disabling disease in women <50 years of age due to a high number of years lived with disability, resulting in a very high global socioeconomic burden. Robust evidence exists on the association between migraine with aura and increased incidence of cardiovascular disease (CVD), in particular ischaemic stroke. People with migraine with aura have an increased risk of atrial fibrillation, myocardial infarction, and cardiovascular death compared with those without migraine. Ongoing studies investigate the relation between migraine and angina with non-obstructive coronary arteries and migraine patients with patent foramen ovale. Medication for the treatment of migraine can be preventative medication, such as beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, antiepileptics, antidepressants, some of the long-acting calcitonin gene-related peptide receptor antagonists, or monoclonal antibodies against calcitonin gene-related peptide or its receptor, or acute medication, such as triptans and calcitonin gene-related peptide receptor antagonists. However, these medications might raise concerns when migraine patients also have CVD due to possible (coronary) side effects. Specifically, knowledge gaps remain for the contraindication to newer treatments for migraine. All cardiologists will encounter patients with CVD and migraine. This state-of-the-art review will outline the basic pathophysiology of migraine and the associations between migraine and CVD, discuss current therapies, and propose future directions for research.
KW - Cardiovascular disease
KW - INOCA
KW - Medication
KW - Migraine
KW - Sex differences
KW - Stroke
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85167469787&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/37345664
UR - http://www.scopus.com/inward/record.url?scp=85167469787&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/eurheartj/ehad363
DO - https://doi.org/10.1093/eurheartj/ehad363
M3 - Review article
C2 - 37345664
SN - 0195-668X
VL - 44
SP - 2815
EP - 2828
JO - European Heart journal
JF - European Heart journal
IS - 30
ER -