Study Identifies Link Between Migraine, Abdominal Aortic Aneurysms

Results of a nationwide population-based cohort study revealed an association between migraine and the development of abdominal aortic aneurysms (AAA) after adjusting for several comorbidities and medications. Findings were published in the International Journal of Environmental Research and Public Health.

“Previous studies have indicated that patients with migraine have a higher prevalence of risk factors known to be associated with cardiovascular diseases,” while shared epidemiology and molecular mechanisms between migraine and AAA also exist, researchers wrote. For example, hypertension, hyperlipidemia and smoking are risk factors for both conditions.

To evaluate whether associations exist between migraine and AAA, investigators used the National Health Insurance Research Database (NHIRD) in Taiwan. Taiwan’s National health Insurance (NHI) Program includes over 99% of the population and was launched in 1995.

Data from an NHIRD subset, the Longitudinal Health Insurance Database 2005 (LHID 2005), were used for the current analysis. Researchers selected patients in the LHID 2005 database who were at least 20 years old and newly diagnosed with migraine. Individuals were followed up with between 2000 and 2015, while patient and control cohorts were selected by 1:4 matching according to age, sex and comorbidities.

Of the 1,936,512 patients in the LHID 2005-2015, 53,668 (2.77%) were identified as diagnosed with migraine. The study cohort consisted of 1022 patients while 4088 matched patients formed the comparison cohort.

Analyses revealed:

• Patients with migraine had a significantly higher cumulative risk of 3.558 of developing an AAA 5 years after the index date compared with patients without migraine (P = .006).
• At the end of the 15-year follow-up period, a significantly higher incidence of AAA (0.98%) was observed in the patients with migraine than in those without migraine (0.24%) (P = .003).
• Male sex, intracerebral hemorrhage, and coronary artery disease were also associated with an increased risk of developing AAA.
• Males with migraine had a 5.976-fold (P = .001) increased risk of AAA compared with females without migraine.
• Patients with migraine with aura were more likely to develop AAA than patients who had migraine without aura.

“The mechanisms by which migraine might increase AAA are probably multifactorial,” authors wrote. Although the use of non-steroidal anti-inflammatory drugs may increase the risk of cardiovascular diseases, the current analysis found medications were not associated with an increased incidence of AAA among migraineurs.

Based on the findings, researchers recommend male patients with migraine undergo additional screenings for AAA as they had a nearly 6-fold increased risk of AAA development.

The NHIRD registry does not include detailed information on family histories, health-related lifestyle factors, quality of life or imaging. Lack of data on those potentially confounding factors mark a limitation to the study.

Reference

Lin J, Tung C, Wang J, et al. The association between migraine and abdominal aortic aneurysms: a nationwide population-based cohort study. Int J Environ Res Public Health. Published online April 20, 2021. doi:10.3390/ijerph18084389