Migraine can be a risk factor for cardiovascular disease

You may have made the unfortunate acquaintance of the throbbing, pulsing head pain on one side that leads to a feeling of nausea and incapacitates you all day.

Circulation


Owen Wiseman
@AVogel_ca


16 October 2018

What is a migraine?

A migraine is a severe form of a headache that is often preceded by something known as an aura which will be covered further on in the article. They typically occur on one side of the head, incapacitate the individual, and last anywhere from two to 72 hours. These are commonly accompanied by sensitivity to light, noise, or smells, and a feeling of nausea or actually vomiting.

What causes a migraine?

This is still a question of debate. With advancements in imaging, scientists are better able to determine whether a migraine is due to a vascular, neurological, or multi-factorial cause. Some individuals can clearly identify their triggers and have an easy time avoiding them, while others are often unsure.

Are there any warning signs?

As mentioned earlier, migraines are often preceded by something known as an aura. These are sensory disturbances that range from a creeping loss of vision to a tingling feeling in your hands or face. At 83%, the most common form of aura is seeing stars or flashes. They have been associated with something known as cortical spreading depression (CSD). This is a slow wave of hyperactivity in the neurons of the brain followed by a period of inhibition. That period of inhibition is quite dangerous as it lowers the amount of blood perfusing through the blood vessels of the brain.

Imagine a water turbine that depends on a constant supply of water to keep it running and supplying energy. If the water suddenly stops flowing, that turbine stops functioning, much like the areas of the brain downstream from the CSD. This might contribute to areas of the brain that process vision for instance to have their function interrupted leading to the vision symptoms preceding a migraine.

How can they contribute to cardiovascular disease?

A large study consisting of 51,032 individuals suffering from migraines and 510,320 without the debilitating condition looked to compare their risk of cardiovascular events. They were followed for 19 years and those with migraines were more likely to experience stroke, heart attack, and atrial fibrillation.

The researchers also accounted for many factors such as whether the individual smoked and their body mass index, two factors that are already known to increase the risk of CVD (cardio vascular disease). Understanding the exact connection is subject to future research as the mechanisms are complex. These risks were also higher in those who experience auras, potentially due to the impacts of cortical spreading depression.

What other risk factors should I be aware of?

While controlling biological sex may be something that occurs in the future, it is unavoidable currently. That said, at 15%, women are at an almost 2-fold risk for experiencing migraines than their male counterparts at only 6%. Age is another factor with migraine incidence peaking around 40 years.

Overuse of acute migraine medication can actually increase the frequency of the headaches! Overuse would be defined as taking analgesics (pain relievers) for more than 15 days per month or taking triptans for more than 10 days per month. Discontinuing the overuse of these medications alleviated headaches in the study participants.

Finally, watch that weight! Obesity has been shown to be associated with a greater number of migraines and puts you at a higher risk of developing a chronic daily headache.

Are there steps I can take to improve my cardiovascular profile?

Hopefully the information presented hasn’t scared you, but empowered you to take important steps to protect your health. Losing weight to achieve a healthy BMI has benefits that are too numerous to list.

This could involve increasing your daily exercise and introducing healthier eating habits into your daily life. In one clinical trial, exercise was shown to reduce migraine attacks by 0.93 per month. In regards to diet, caffeine withdrawal and monosodium glutamate (MSG) were shown to have the highest rates of triggering migraine attacks. Following close behind, alcohol was reported to precipitate a migraine in 29-36% of study participants.

Is there anything I can use to prevent cardiovascular disease?

Constriction of the blood vessels, or vasoconstriction, is a sure way to prevent blood from getting where it needs to be in a timely fashion. Herbs such as Ginkgo biloba contain active components known as terpenoids that encourage the dilation of blood vessels. Tinctures such as Ginkgo and tablets such as Ginkgo Extra are made from the leaves of the tree and provide the terpenoids necessary for its benefits. The herb has also been shown to discourage the activity of the platelet-activating factor (PAF) receptor which is a pro-inflammatory and has been shown to be released during the beginnings of a migraine attack. Preventing PAF from being released in the first place could help alleviate the debilitating pain of a migraine and take the burden off your mind.

References

https://www150.statcan.gc.ca/n1/en/catalogue/82-003-X201400614033
https://www.aafp.org/afp/2013/0515/p682.html
https://www.aafp.org/afp/2018/0215/p243.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690985/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049472/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236524/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462501/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813301/
https://www.ncbi.nlm.nih.gov/pubmed/17495755
https://www.ncbi.nlm.nih.gov/pubmed/20170844
https://www.ncbi.nlm.nih.gov/pubmed/24042483
https://www.ncbi.nlm.nih.gov/pubmed/24867850
https://www.ncbi.nlm.nih.gov/pubmed/25230799
https://www.ncbi.nlm.nih.gov/pubmed/27389092
https://www.ncbi.nlm.nih.gov/pubmed/27699780

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