1.4 INCREASED AORTIC STIFFNESS IN YOUNG SUBJECTS WITH MIGRAINE

Abstract

Background: Migraine is associated with an increased risk for ischemic stroke and other cardiovascular (CV) events, including angina, myocardial infarction, and CV death. However, the mechanisms which link migraine to CV disease remain uncertain. In the present case-control study, we hypothesized that aortic stiffness, a direct measure of pulse wave velocity and an independent predictor of stroke and CV disease, may be increased in young migraineurs with no overt CV disease or major CV risk factors. Methods and Results: We studied 41 individuals with migraine (age 31±8 years, 82% females, blood pressure 118/73±12/9 mmHg) and 41 age- and sex-matched healthy control subjects. In all participants, carotid-to-femoral pulse wave velocity was determined by applanation tonometry (SphygmoCor). Cases and controls were free from overt CV disease, diabetes, and major CV risk factors. Subjects with migraine had a higher aortic pulse wave velocity than matched control subjects (7.4±1.2 vs 6.5±1.1m×s−1, p=0.001). Age, mean arterial pressure as a measure of distending pressure and the presence of migraine (all p<0.05) independently predicted aortic pulse wave velocity when a consistent number of cardiovascular risk factors was simultaneously controlled for. Conclusions: Migraine is independently associated with an increased aortic stiffness. This finding, obtained in young subjects without major cardiovascular risk factors, may represent one possible mechanism underlying the increased cardiovascular risk in patients with migraine.