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Migraine Age of Onset and Association With Ischemic Stroke in Late Life: 20 Years Follow-Up in ARIC.

TitleMigraine Age of Onset and Association With Ischemic Stroke in Late Life: 20 Years Follow-Up in ARIC.
Publication TypeJournal Article
Year of Publication2019
AuthorsX Androulakis M, Sen S, Kodumuri N, Zhang T, Grego J, Rosamond WD, Gottesman RF, Shahar E
Secondary AuthorsB Peterlin L
Date Published2019 04
KeywordsAge of Onset, Aged, Brain Ischemia, Comorbidity, Female, Follow-Up Studies, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Migraine with Aura, Migraine without Aura, Stroke, United States

BACKGROUND AND PURPOSE: To evaluate the association between cumulative exposure to migraine and incidence of ischemic stroke in the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: In this ongoing, prospective longitudinal community-based cohort, participants were interviewed to ascertain migraine history at the third visit (1993-1995), followed for ischemic stroke incidence over 20 years. We performed a post hoc analysis to evaluate the association between the age of migraine onset and ischemic stroke.

RESULTS: We identified 447 migraineurs with aura (MA) and 1128 migraineurs without aura (MO) among 11,592 black and white participants. There was an association between the age of MA onset ≥50 years old (average duration = 4.75 years) and ischemic stroke when compared to no headache group (multivariable adjusted HR = 2.17, 95% CI [1.39-3.39], P 

CONCLUSION: As compared to the no headache participants, increased stroke risk in late life was observed in participants with late onset of MA. In this cohort, longer cumulative exposure to migraine with visual aura, as would be expected with early onset of migraine, was not associated with increased risk of ischemic stroke in late life. This study underscores the importance of the age of onset of MA in assessing stroke risk in older migraineurs.

Alternate JournalHeadache
PubMed ID30663778