Migraine is associated with an increased risk of hypertension in women after menopause, according to a large cohort study. "Since previous research shows migraine increases the likelihood of cardiovascular events, identification of additional risk factors such as the higher likelihood of high blood pressure among people with migraine could aid in individualized treatment or prevention," Dr. Gianluca Severi of the University of Florence, in Italy, told Reuters Health by email. Dr. Severi and colleagues note in a paper in Neurology that, "In women, migraine prevalence decreases after menopause, but no studies have determined if migraine is associated with hypertension after menopause." To do so, the researchers studied women participating in the French E3N cohort. Participants returned mailed questionnaires completed every two to three years between 1990 and 2014. The average response rate at each cycle was 83%. After exclusions because of undetermined menopausal status, reports of cardiovascular disease and a diagnosis of hypertension before menopause, the final study population consisted of more than 56,000 menopausal women free of hypertension. Incident hypertension cases were based on self-report. However, to assess the accuracy of the data, the team examined reimbursements for blood-pressure lowering medications from the MGEN health insurance plan drug claim database. In all, 82% of those reporting hypertension were reimbursed for hypertensive medications. Migraine was classified as ever or never at each questionnaire cycle; using the MGEN reimbursement database again, the researchers identified reimbursements for drugs commonly prescribed as treatment for people with migraine. At the start of follow-up, 9,543 women reported having ever had migraine and that had increased to 11,030 in 2005. Age at menopause was determined by a combination of variables. If otherwise unavailable, the median age at menopause for the cohort (51 years for natural menopause, 47 years for surgical menopause) was imputed. During 826,419 person-years, there were 12,501 cases of incident hypertension, including 3,100 in women with migraine and 9,401 in those without migraine. The median age at diagnosis was 64 years. Migraine was associated with an increased risk of hypertension in menopausal women (hazard ratio, 1.29). The association was significantly stronger in women who used hormone-replacement therapy (HR, 1.34) than in those who did not (HR, 1.19). Age at menopause did not modify the association nor did the type of menopause. No significant difference in hypertension was seen between women who had migraine with aura versus those with migraine without aura. The researchers note that data on the severity of hypertension was unavailable for the majority of participants, but, concluded Dr. Severi "Doctors may want to consider women with a history of migraine at a higher risk of high blood pressure." —David Douglas Source
