New insights into the cardiovascular risk of migraine and the role of white matter hyperintensities: is gold all that glitters?
1 Department of Medicine, “G. D’Annunzio” University of Chieti, and Center of Excellence on Aging, “G. D’Annunzio” University Foundation, Chieti, Italy
2 Center of Excellence on Headache, “S.S. Annunziata” Hospital, Chieti, Italy
3 Department of Clinical and Molecular Medicine, Regional Referral Headache Centre, “Sant’Andrea” Hospital, “Sapienza” University, Rome, Italy
4 Institute of Surgical Pathology, “G. D’Annunzio” University, Chieti, Italy
5 Private address: via Carlo de Tocco n. 3, Chieti, 66100, Italy
The Journal of Headache and Pain 2013, 14:9 doi:10.1186/1129-2377-14-9Published: 1 February 2013
The role of migraine as an independent risk factor for cardiovascular events has been debated for several years, while it is more established for ischemic stroke. Recently, new studies have examined the likelihood of migraine to determine cardiovascular events, supporting the hypothesis of a predominant role in patients with migraine with aura, the risk including both sexes. In the literature, multiple pathophysiological mechanisms are described to explain this association, and are here discussed. Furthermore, the emerging evidence that a higher headache frequency and long-term migraine may worsen the cardio-metabolic profile in migraineurs (e.g. with a higher Framingham risk score and risk of developing atherosclerosis, insulin resistance and metabolic syndrome) makes it increasingly necessary to reduce the number and severity of attacks, not only to alleviate the painful symptoms, but also to improve the prognosis in these patients.