Analysis Links Migraine With Increased Risk of Hypertension

Findings of a population-based prospective study revealed a significant association between self-reported migraine and incident hypertension. Results were published in the European Journal of Public Health and underscore the importance of hypertension prevention and control among working-age migraineurs, researchers wrote.

Specifically, results of the Finnish study showed that individuals with migraine at baseline were 1.35 times more likely to have hypertension after 15 years of follow-up compared with those without initial migraine.

Hypertension is associated with increased morbidity and mortality from cardiovascular disease (CVD) and was estimated to affect around 31% of adults globally in 2010. “Although any substantial reduction of blood pressure dramatically reduces the risk for CVD, prevalent hypertension remains a principally uncontrolled public health concern,” the authors noted.

Past research has explored a possible link between migraine and hypertension, but epidemiological evidence is controversial, they said.

The investigators set out to better elucidate the relationship between the 2 conditions by assessing data from the Finnish Health and Social Support (HeSSup) Study. Participants filled out baseline questionnaires in 1998 and were followed up with in 2003 and 2012. All individuals included (n = 8593) did not have hypertension at baseline.

Information was also linked with an additional registry of special reimbursement medication for hypertension for validation purposes. “With the use of 2 data sets, untreated or unreported hypertension was eliminated from the study population,” researchers said.

Analyses revealed hypertension was significantly (P < .001) more prevalent among migraineurs (n = 465; 26.9%) than among the other participants (n = 1483; 21.7%). Hypertension was also more prevalent among:

• women compared with men
• older people compared with younger individuals
• persons with the least occupational training compared with those having the highest occupational training
• persons living alone
• persons with a body mass index (BMI) of 25 or higher
• persons with heavy alcohol consumption
• current regular smokers with 5 or more daily cigarettes

In addition, self-reported migraine remained a significant independent predictor for hypertension (odds ratio, 1.37; 95% CI, 1.20-1.57) in multivariable logistic regression analyses adjusted for gender, age, occupational training, living alone, metabolic equivalent of task, BMI, alcohol consumption, and smoking status, authors said.

One potential explanation for this relationship could be the renin angiotensin system, which is involved in both hypertension and the central nervous system (CNS). Although the exact underlying cause of migraine is unknown, the condition may depend on the activation of the trigeminally mediated vascular pathway and CNS dysfunction.

In the current analysis, data did not differentiate between migraine with and without aura, marking a limitation.

“The background of the association studied is multifactorial and further studies are needed,” the authors wrote. “Attention should be paid to both prevention of hypertension and its early detection in working-age migraine patients. This emphasizes the importance of regular blood pressure monitoring at all levels of health care,” they concluded.

Reference

Entonen AH, Suominen SB, Sillanmäki LH, et al. Prevalent migraine as a predictor of incident hypertension. Eur J Public Health. Published online January 11, 2022. doi:10.1093/eurpub/ckab219