Migraine and cardiovascular disease: What cardiologists should know

Deborah N. Kalkman, Emile G.M. Couturier, Abdelhak El Bouziani, Jorge Dahdal, Jolien Neefs, Janneke Woudstra, Birgit Vogel, Daniela Trabattoni, Antoinette Maassenvandenbrink, Roxana Mehran, Robbert J. De Winter, Yolande Appelman

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)2815-2828
Number of pages14
JournalEuropean Heart Journal
Volume44
Issue number30
DOIs
StatePublished - 7 Aug 2023

Keywords

  • Cardiovascular disease
  • INOCA
  • Medication
  • Migraine
  • Sex differences
  • Stroke

Fingerprint

Dive into the research topics of 'Migraine and cardiovascular disease: What cardiologists should know'. Together they form a unique fingerprint.

Cite this