A migraine is no ordinary headache. It is an inherited tendency to have headaches that are accompanied with sensory disturbances. A migraine is caused by instability in the manner in which the brain deals with incoming sensory information. This instability can further be influenced by physiological factors such as lack of sleep, exercise patterns, hunger or particular foods. A migraine is no doubt a complex condition and has a wide variety of symptoms that vary from person to person. For years now, a debate has been raging on whether having a migraine increases the risk of having cardiovascular diseases. It has already been established that having a migraine with aura is a risk factor for ischemic lesions of the brain. Brain ischemia is a condition in which the blood flow to the brain is insufficient to meet the metabolic demands of the body. This leads to a poor oxygen supply reaching the brain, ultimately resulting in the death of brain or cerebral tissue and can also result in a brain stroke, commonly known as an ischemic stroke. Recent research studies have also linked both types of a migraine (with aura and without aura) to a wide variety of ischemic vascular disorders, such as angina, myocardial infarction, claudication, coronary revascularization and ultimately cardiovascular mortality. Therefore, the association between a migraine and cardiovascular diseases is an interesting one and one that is yet to reach a globally acceptable conclusion.

Migraines & Cardiovascular Diseases

Many people are afraid that having a migraine is a symptom that a stroke is lurking on the horizon. Others worry that their risk of having a stroke goes up during a migraine attack. While there is little evidence to actually prove that a stroke is likely to occur during a migraine attack, certain factors do suggest that people suffering from a migraine can be at a higher risk for developing certain cardiovascular diseases. As there is a throbbing nature to the pain in a migraine, scientists suggest that the blood vessels are related directly in causing the pain. Furthermore, migraines tend to worsen with exercise or stress. This is another factor that is associated with an increase in the body's blood pressure and also has symptoms similar to a stroke.

Cardiovascular Conditions Believed to Increase in Frequency with Migraine

There are some cardiovascular conditions that are believed to possibly increase in frequency with a migraine. These include:

  • Raynaud's phenomenon.
  • High blood pressure.
  • Ischemic heart disease.

Structural heart conditions are also many times associated with a migraine. These might include changes in the actual heart chambers and valves. While these disorders are not supposed to cause a migraine, but they are likely to occur at an increasing frequency in people who suffer from a migraine.

Connection Between Migraine and Stroke

Stroke and migraine are both common disorders. While stroke generally affects elderly men, migraine is usually seen in young women. However, studies over the past 40 years have shown that there is an independent link between a migraine and stroke. While the relationship between migraines and stroke is still being properly established, scientists have established a list of ways in which the two conditions may be connected. These include:

  • A migraine causes stroke or stroke occurs during a migraine attack.
  • A migraine is a risk factor for stroke and it has been seen in studies that stroke occurs more frequently in a person who suffers from a migraine. However, it is to be noted that a stroke did not occur during a migraine attack.
  • The symptoms of a migraine often mimic those of a stroke and vice versa.
  • Ischemia or a hemorrhage can trigger a migraine-like event.
  • A migraine and stroke can often share a common cause. For example, a cardiac shunt or in case of an abnormality of the blood vessels due to an underlying genetic condition.
  • Stroke-like lesions are seen on MRI without the symptoms of an actual stroke in people who suffer from a migraine.
  • Therefore, one can say with reasonable surety that there is definitely some link between migraines and strokes.

Does Migraine Increase the Risk of Stroke? Who is at Risk?

The overall risk of migraine-related stroke is quite low. In women who suffer from a migraine, however, the risk of stroke on an annual basis is about three times more than what it is for women who do not have a migraine.

A migraine with aura is the main type of a migraine that is associated with stroke. A migraine with aura affects nearly 25% of the total people who suffer from a migraine. The main type of stroke that is associated with a migraine is an ischemic stroke that results from decreased blood flow to a certain part of the brain. People with a migraine are also at an increased risk for a hemorrhagic stroke, which results from bleeding into or around the brain. Women who suffer from a migraine with aura are 3 times more likely to have a stroke as compared to women who do not suffer from a migraine at all. Women are also at a higher risk of stroke than men who suffer from a migraine with aura. The surprising statistic is that younger people (below 45 years of age) are actually at a higher risk for migraine-associated stroke as compared to older people.

People who already have most of the traditional stroke risk factors like high blood pressure, high cholesterol, or type 1 or type 2 diabetes, and suffer from a migraine with aura as well, are at the highest risk of getting a stroke.

Migraine with Aura or a Mini-Stroke?

Due to the nature of their symptoms, often times people find it difficult to tell the difference between a migraine with aura and a transient ischemic attack (ITA), also known as a “mini-stroke.” The common symptoms for both these conditions include:

  • Brief, focal neurological symptoms.
  • These may or may not be followed by headaches.
  • Symptoms in aura headaches are usually increasing in nature.
  • Aura will tend to grow brighter or become crescent with jagged edges if it’s a migraine attack.
  • Symptoms of a TIA will be sudden in nature such as one-sided weakness, one-sided vision loss, and numbness.

One-sided vision loss and one-sided weakness also occur in a migraine with aura, making it difficult to clinically differentiate it from TIA. Both the conditions also present with normal MRIs and diagnostic labs. Furthermore, TIA can sometimes also give rise to an electrical brain phenomenon known as cortical spreading depression that manifests itself as an aura and is known as a symptomatic migraine. In such cases, it becomes extremely difficult to tell the two conditions apart as the aura symptoms are presented due to the TIA event which is undergoing in the body.

How to Lower Your Risk of Stroke and Heart Disease Even If You Have Migraine?

Here are some tips that you can follow to lower your risk of having a stroke or other cardiovascular diseases if you suffer from a migraine.

  • Maintain a healthy diet.
  • Drink plenty of water.
  • Exercise regularly.
  • Get at least 8 hours of sleep.
  • Avoid smoking.
  • Get tested and treated for conditions that are known to cause stroke and heart diseases, such as high blood pressure, high cholesterol and diabetes.
  • Use strategies to prevent migraines. Apart from lowering your migraine attacks, they may also prevent an incident of stroke.
  • Apart from your migraine preventive medicines, enquire from your physician about medicines that can lower inflammation and reduce clotting. Daily aspirin doses are an excellent remedy.
  • Enquire about medicines for repairing the endothelium, such as a statin with Vitamin D.
  • Avoid using contraceptives that contain estrogen, especially if you smoke and have a family history of stroke or blood clots.
  • Do not use medications that restrict blood vessels if you have a history of stroke or heart disease or if you have had attacks of a hemiplegic migraine in the past.

Conclusion

A migraine is known to be a life-changing condition with no known cure as of now. By maintaining a better and a healthier lifestyle, people suffering from a migraine can lower their risk of cardiovascular disease and stroke. The good news is that since you must already be taking many preventive steps for your migraine, these are likely to help you in decreasing your risk for cardiovascular disease. Now that you are aware of the risks involved, you can start proactively following a lifestyle that includes key aspects of migraine prevention and also keeps your heart healthy.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: November 13, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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