Hypertension and migraine: two enemies of our health

5

What impact do hypertension and migraine have on the risk of stroke? This is the question that the Italian Society of Hypertension (SIIA) and the Italian Society for the Study of Headaches (Società Italiana per lo Studio delle Cefalee – SISC) have set out to answer by promoting an epidemiological study called MIRACLES.

Some of the educational objectives of this study are to spread knowledge of the criteria for a correct diagnosis of hypertension and migraine, and increase cooperation between specialist centers and physicians to improve their ability to share diagnostic criteria and therapeutic procedures.

Hypertension is the greatest predictive factor of stroke and is involved in 70% of all cases, contributing to about 12.7 million cases of stroke per year worldwide. In the Framingham study, the risk of stroke in hypertensive subjects was 3 times higher than in normotensive subjects, in both men and women. The Multiple Risk Factor Intervention Trial (MRFIT) highlighted that systolic blood pressure is a stronger predictive factor of death by stroke than diastolic blood pressure. A recent analysis of observational studies highlighted that not only is death rate by stroke positively correlated with blood pressure values and age, but it decreases in all age groups when systolic and diastolic blood pressure is no higher than 115 and 75 mmHg. A recent meta-analysis of the main randomized clinical studies has shown that a reduction of 5-6 mmHg in diastolic blood pressure and 10-12 mmHg in systolic blood pressure is associated to a 38% reduction in the risk of stroke.

Migraine is emerging as a risk factor for stroke; it is considered an independent risk factor for ischemic stroke, particularly in women below 45 years of age, with additional risk factors being cigarette smoking and the use of oral contraceptives.

A recent review of observational studies highlighted that the risk of stroke doubles in those who suffer from migraines (by about 3 times for migraine with aura and about 1.5 times in migraine without aura); and the risk can increase up to 8 times as much with the use of oral contraceptives.  We recommend you always keep your blood pressure levels in control and see your doctor if you experience strong migraines.

 

Original scientific articles below: