High Diastolic Blood Pressure Linked to Greater Odds of Females Having a Migraine

Antoinette Maassen van den Brink, PhD

Credit: Erasmus MC University

A new study published in the online issue of Neurology, the medical journey of the American Academy of Neurology, revealed a high diastolic blood pressure is linked to slightly greater odds of ever having a migraine in female participants.¹

Investigators sought to examine whether well-known risk factors for cardiovascular diseases, such as diabetes, smoking, obesity, and high cholesterol, impacted the odds of having a migraine. The primary objective was to assess sex-specific associations between cardiovascular risk factors and the lifetime prevalence of migraine.

“Previous research shows that migraine is linked to a higher risk of cardiovascular events such as stroke, heart disease, and heart attack, but less is known about how risk factors for cardiovascular events relate to having migraine,” said investigator Antoinette Maassen van den Brink, PhD, of Erasmus MC University Medical Center in Rotterdam, the Netherlands, in a press release.²

Investigators, led by Linda Maassen van den Brink and Daniel Bos, MD, PhD, conducted a cross-sectional study with 7266 community-dwelling middle-aged and elderly participants.¹ The sample came from an ongoing population cohort study (Rotterdam Study) with a median age of 6.6 years (IQR, 56.4 – 74.8). More than half of the sample was female (57.5%).

Participants had physical exams, provided blood samples, and were asked questions about migraines during structured interviews. For instance, they were asked if they ever experienced a headache with severe pain that impacted daily activities.

Investigators obtained data on the lifetime prevalence of migraine and the cardiovascular risk factors of current smoking, obesity, hypercholesterolemia, hypertension, and diabetes mellitus. The team also collected data on pack-years of smoking, lipid levels, systolic and diastolic blood pressure, body mass index (BMI), and fasting glucose levels.

In total, only 14.9% had a previous or current migraine. In the analysis patients with a migraine were age-matched to patients without a migraine. From there investigators performed conditional logistic regression analyses to assess the sex-stratified association between cardiovascular risk factors and migraines.

When investigators adjusted for cardiovascular risk factors, such as physical activity, and education level, they found female participants with a greater diastolic blood pressure had 16% increased odds of having a migraine (95% confidence interval [CI], 1.04 – 1.29). There were no observed associations for systolic blood pressure. This suggests migraines may be linked to a slightly reduced function of the small blood vessels, as opposed to a reduced function of the large blood vessels.

The team also found no associations for female participants with high cholesterol or obesity. Furthermore, current smoking (odds ratio [OR], 0.72; 95% CI 0.58 – 0.89) and diabetes mellitus (OR 0.75, 95% CI 0.57 – 0.99) were significantly linked to lower odds of having a migraine in females.

“These results should be interpreted with caution, as they do not prove that smoking causes a lower risk of migraine. Instead, smoking might trigger migraine attacks and therefore, people who choose to smoke are less likely to be people who have migraine,” Maassen van den Brink said.²

Additionally, male participants had no association between cardiovascular risk factors and migraines.¹ Investigators highlighted this finding may have been limited by only a small number of male participants having a migraine.

“Our study suggests that overall, migraine is not directly related to traditional risk factors for cardiovascular disease,” said Maassen van den Brink.² “Because we looked at people who were middle-age and older, future studies are needed in younger groups of people who are followed for longer periods of time.”

References

1. ^{Al-Hassany, L, Acarosy, C, Ikram, K, et al. Sex-Specific Association of Cardiovascular Risk FactorsWith Migraine. Neurology. 2024;103:e209700. doi:10.1212/WNL.0000000000209700}
2. ^{Are Cardiovascular Risk Factors Linked to Migraine? EurekAlert! July 31, 2024. https://www.eurekalert.org/news-releases/1052629?. Accessed July 30, 2024.}