Migraine and coronary heart disease in women and men

Objective.-We evaluated migraine as an independent risk factor for subsequent coronary heart disease (CHD) events among women in the Women's Health Study (WHS) and men in the Physicians' Health Study (PHS). Background.-Although several studies have suggested that migraine is associated with increased risk of stroke, there are few and conflicting data on whether migraine predicts risk of future CHD events. Methods.-The WHS is an ongoing randomized, double-blind, placebo-controlled trial of low-dose aspirin and vitamin E in the primary prevention of cardiovascular disease and cancer in 39,876 women health professionals aged greater than or equal to45 years in 1993, and the PHS is a completed randomized, double-blind, placebo-controlled trial of aspirin and beta-carotene in the primary prevention of cardiovascular disease and cancer in 22,071 men physicians aged 40 to 84 years in 1982. Primary endpoints were defined as major CHD (nonfatal myocardial infarction [MI] or fatal CHD) and total CHD (major CHD plus angina and coronary revascularization). Results.-After adjusting for other CHD risk factors, female health professionals and male physicians reporting migraine were not at increased risk for subsequent major CHD (women: relative risk [RR], 0.83; 95% confidence interval [CI], 0.53 to 1.29; men: RR, 1.02; 95% CI, 0.79 to 1.31) or total CHD (women: RR, 1.01; 95% CI, 0.76 to 1.34; men: RR, 0.98; 95% CI, 0.82 to 1.18). When considered separately, there was also no increase in risk of MI or angina. Conclusion.-These prospective data suggest that migraine is not associated with increased risk of subsequent CHD events in women or men.