Migraine Headache and Ischemic Stroke Risk: An Updated Meta-Analysis

Details

• Personal Author:
  Dalal D ; Jayakumar M ; Jones MR ; Kahn SR ; Nazarian S ; Spector JT
• Description:
  Background: Observational studies, including recent large cohort studies that were unavailable for prior meta-analysis, have suggested an association between migraine headache and ischemic stroke. We performed an updated meta-analysis to quantitatively summarize the strength of association between migraine and ischemic stroke risk. Methods: We systematically searched electronic databases, including MEDLINE and EMBASE, through February 2009 for studies of human subjects in the English language. Study selection using a priori selection criteria, data extraction, and assessment of study quality were conducted independently by reviewer pairs using standardized forms. Results: Twenty-one (60%) of 35 studies met the selection criteria, for a total of 622,381 participants (13 case-control, 8 cohort studies) included in the meta-analysis. The pooled adjusted odds ratio of ischemic stroke comparing migraineurs with nonmigraineurs using a random effects model was 2.30 (95% confidence interval [CI], 1.91-2.76). The pooled adjusted effect estimates for studies that reported relative risks and hazard ratios, respectively, were 2.41 (95% CI, 1.81-3.20) and 1.52 (95% CI, 0.99-2.35). The overall pooled effect estimate was 2.04 (95% CI, 1.72-2.43). Results were robust to sensitivity analyses excluding lower quality studies. Conclusions: Migraine is associated with increased ischemic stroke risk. These findings underscore the importance of identifying high-risk migraineurs with other modifiable stroke risk factors. Future studies of the effect of migraine treatment and modifiable risk factor reduction on stroke risk in migraineurs are warranted. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Epidemiology Occupational Health Risk Assessment Risk Factors Safety
• Keywords:
  Author Keywords: Cerebral Ischemia Cohort Studies Ischemic Stroke Meta-analysis Neurological System Risk Factors Statistical Analysis Stroke
• ISSN:
  0002-9343
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; OSHA Region 10 ; OSHA Region 3 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  123
• Issue:
  7
• NIOSHTIC Number:
  nn:20054840
• Citation:
  Am J Med 2010 Jul; 123(7):612-624
• Contact Point Address:
  Saman Nazarian, MD, Division of Cardiac Arrhythmia, Johns Hopkins Hospital, Carnegie 592C, 600 N. Wolfe Street, Baltimore, MD 21287
• Email:
  snazarian@jhmi.edu
• Federal Fiscal Year:
  2010
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  The American Journal of Medicine
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7e4a32ce5c92b107f1948567fa59373b6131d9aa0d731a4b2e46b3c4b1f3fa5b7a5942f19d3d23eac21f55aca1d6e7e1c65ad17d634af609bfa61accf384b5ee
• Download URL:
  https://stacks.cdc.gov/view/cdc/217260/cdc_217260_DS1.pdf
• File Type:
  [PDF - 1.38 MB ]