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Migraines Raise Stroke Risk

Migraines With Vision Changes Have Greatest Risk
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WebMD Health News

Feb. 3, 2005 (New Orleans) -- Two new studies show migraine headaches, particularly ones that affect vision, are a risk factor for stroke in young people.

Steven Kittner, MD, MPH, tells WebMD that a migraine with some type of visual change increases a woman's risk of having a stroke by 25% to 70%. Kittner is professor of neurology at the University of Maryland School of Medicine.

Some people experience vision changes prior to the onset of the migraine headache. "The stroke risk appears to be greatest for women who have some vision loss rather than women who have floaters or heat wave lines," Kittner says.

The federal government estimates that migraine headaches affect about 17% of American women and 6% of American men. "About 5% of the women with migraine have migraine with aura, so this is a very common condition," says Kittner, who reported his research today at the American Stroke Association's International Stroke Conference 2005.

Kittner's study, which included 963 women, between ages 15 and 49, only apply to women who have recurring migraine headaches.

Migraines Can Double Stroke Risk

Kittner and his colleagues defined migraine patients as those who had five or more migraine headaches a year. Migraine with vision changes was defined as patients who had two or more migraine headaches with visual disturbances during a year.

A second study on 238 men and women shows that any type of migraine headache increases the risk of a stroke in young people. Massimo Camerlingo, MD, head of the neurologic unit at Policlinico San Marco in Osio Sotto, Italy, says that migraine headaches are associated with 2.7 times greater risk for stroke among young people.

While stroke in young people -- teens to mid-40s -- isn't as common as stroke in elderly persons, "it occurs in about 1 in 5,000 young women per year. Adding migraine with [vision changes], it changes the equation so the risk is about 1 in 2,500," Kittner says.

Any Risk for First-Time Migraine?

Larry Goldstein, MD, professor of medicine at Duke University School of Medicine, tells WebMD that any person who has a migraine with vision changes -- especially a first-timer -- "needs to be carefully evaluated to determine if it is true migraine or if there are other causes."

Kittner agrees with this suggestion, noting that "any person without regard to age or gender who has new onset migraine with visual loss should have the symptoms investigated to rule out other medical conditions such as detached retina or [ministroke]."

Kittner says that people with migraine -- especially young women -- should also "stop smoking, make sure their blood pressure is well controlled, eat a healthy diet, and exercise."

Goldstein agrees that careful attention to all those stroke risk factors is good advice for migraine sufferers.

Camerlingo says blood pressure control is especially important for migraine sufferers. In his study people with high blood pressure and migraine had an almost ninefold increase in stroke risk.

Noting that some studies have suggested that birth control pills may increase the risk of stroke, "I suggest that women who have migraine should discuss the use of oral contraceptives with their physician. If they develop visual symptoms with migraine, they should discuss it again," Kittner says.

Kittner and Camerlingo say they started investigating migraine because young stroke victims haven't lived long enough for the traditional stroke risk factors -- smoking, high blood pressure, and obesity -- to have an impact. "So, we started looking at nontraditional risk factors," says Kittner.

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