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Migraine With Vision Loss Ups Stroke Risk

Posted on: Friday, 4 February 2005, 18:00 CST

HealthDayNews -- Women who have migraines that include a loss of vision have a 70 percent higher risk of a stroke compared with women who don't, government researchers report.

Scientists from the U.S. Centers for Disease Control and Prevention presented their findings Feb. 3 at the American Stroke Association's International Stroke Conference in New Orleans. Another study reported at the conference by Italian researchers found that the increased risk for stroke from migraine among young people is independent of other stroke risks such as drinking, smoking or using oral contraceptives.

In the first study, CDC researchers looked at women who had migraine with aura. Aura is a sensory phenomenon such as visual or hearing abnormalities. Previously, migraines with visual aura have been linked with stroke, but it has not been clear if a particular type of visual disturbance is more closely linked with an increased risk of stroke.

In their study, the researchers collected data on 963 women between the ages of 15 and 49 who had participated in the Stroke Prevention in Young Women Study conducted at the University of Maryland School of Medicine. Of the women in the study, 542 had had a stroke.

The research team, lead by Dr. Wayne H. Giles, associate director for science at the CDC's Division of Adult and Community Health, wanted to find out if migraine accompanied by vision loss increased the risk of stroke, as opposed to migraine accompanied by other visual phenomena such as seeing lines and spots.

The team found that vision loss was a significant predictor of stroke. "Women who experience loss of vision as a symptom of migraine have a 70 percent increased risk of stroke compared with women who don't have migraines," Giles said.

According to Giles, about 17 percent of women have migraine, and 5 percent of these have migraine with aura. Among women with aura, more than 90 percent have visual symptoms, such as light sensitivity, seeing lines or spots, seeing flashes of light or temporary loss of vision.

In terms of the overall risk for stroke, migraine with vision loss is a moderate risk factor, Giles said.

"It is not as strong as something like hypertension or smoking, but if these findings are confirmed, it does give clinicians something to look for as they are evaluating women who suffer from migraine," he added.

Women who have these symptoms need to see their doctor and have their symptoms evaluated, Giles advised. "It is important that women who have migraine control their other risk factors for stroke like hypertension and elevated cholesterol. It is also important that they don't smoke," he said.

In addition, women who have migraine and take oral contraceptives need to speak with their doctor about the risk and benefits of oral contraceptives, Giles added.

"Migraine has been found in other studies to be a risk factor for stroke, particularly in women," said Dr. Ralph L. Sacco, director of the Stroke and Critical Care Division at Columbia University College of Physicians and Surgeons in New York City.

"This study adds to our thinking that those with visual symptoms have a little greater risk than those without," Sacco said. "Migraine can be treated and managed. And like any other risk factor, managing the migraine would be helpful."

Sacco also advises that to reduce the risk of stroke, the other common risk factors need to be managed. "If you have migraine, then it is more important to be managing the traditional risk factors as well," he said.

In the second report, researchers led by Dr. Massimo Camerlingo, head of the neurologic unit at Policlinico San Marco in Osio Sotto (Bergamo), Italy, collected data on stroke risk among 238 men and women aged 16 to 44.

The researchers looked at the use of oral contraceptives, wine and cigarette use, blood pressure, migraine history and cardiac rhythm.

Camerlingo's team found no difference between the groups in the use of oral contraceptives, drinking wine or smoking. The researchers found that those who had migraine were 2.7 times more likely to have a stroke compared with those who did not have migraine.

When migraine was combined with high blood pressure, the stroke risk increased ninefold. "The role of migraine in precipitating a stroke in young adults appears to be independent from the usual risk factors and from the consumption of wine, cigarettes and the contraceptive pills," Camerlingo said in a prepared statement.

More information

U.S. Centers for Disease Control and Prevention

The American Stroke Association can tell you more about stroke.

SOURCES: Wayne H. Giles, M.D., M.S., associate director, science, Division of Adult and Community Health, U.S. Centers for Disease Control and Prevention, Atlanta; Ralph L. Sacco, M.D., professor and associate chairman, neurology and epidemiology, and director, Stroke and Critical Care Division, Columbia University College of Physicians and Surgeons, New York City; Feb. 3, 2005, presentation, American Stroke Association International Stroke Conference, New Orleans~EYES~~MIGR~~STRO~~WMEN~

Source: HealthSCOUT

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