The vascular risk associations with migraine: Relation to migraine susceptibility and progression

• Published in: Atherosclerosis Vol. 205; no. 1; pp. 15 - 22
• Main Author: Hamed, Sherifa A
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.07.2009; Elsevier
• Subjects: Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Body Mass Index; Body Weight; C-Reactive Protein - biosynthesis; Cardiology. Vascular system; Cardiovascular; Comorbid risk factors; Comorbidity; Coronary heart disease; Disease Susceptibility; Heart; Homocysteine - blood; Humans; Inflammation; Interleukins - biosynthesis; Medical sciences; Migraine; Migraine Disorders - complications; Migraine Disorders - diagnosis; Risk; Risk Factors; Stroke - complications; Stroke - diagnosis; Tumor Necrosis Factor-alpha - biosynthesis; Vascular Diseases - complications; Vascular Diseases - diagnosis; Vascular wall injury; CRP; homocysteine; C-reactive protein; IL; migraine without aura; body mass index; Migraine; Comorbid risk factors; Inflammation; MA; TNF-α; migraine with aura; interleukin; Vascular wall injury; MoA; tumour necrosis factor-alpha; BMI; Hcy; Nervous system diseases; Cardiovascular disease; Cerebral disorder; Vascular disease; Pain; Central nervous system disease; Atherosclerosis; Risk factor; Vascular wall; Cerebrovascular disease
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2008.10.016

Abstract Migraine is a common disorder in which changes in cortical excitability, neuroinflammation and dysfunction of the vascular wall contribute to its pathophysiology. Repeated attacks of migraine over prolonged periods result in inflammatory arteriopathy of the cranial vessels. Several studies indicate that migraine is associated with special pattern of inflammatory markers and some adverse vascular risk factors including: increased levels of CRP, ILs, TNF-α and adhesion molecules which are markers of systemic inflammation, oxidative stress and thrombosis, increased body weight, high blood pressure, hypercholesterolemia, impaired insulin sensitivity, high homocysteine levels, stroke and coronary heart disease. Such comorbidities are not explained by bias but indicate possible shared underlying pathogenic mechanisms. Recent studies have shown involvement of cranial as well as peripheral vascular dysfunction with migraine indicating that migraine may be a local manifestation of a systemic disease rather than a primary brain phenomenon. The associated inflammatory process of migraine together with the associated adverse medical comorbidities exposes patients to endothelial vascular wall injury which further increases migraine susceptibility and progression as well as increases the risk for atherogenesis. The knowledge that migraine is a risk for vascular diseases raises important clinical implications, recommendations and future perspectives in migraine treatment and prevention.