Risk of stroke in patients with migraine. A register-linked HUNT study

Abstract

Abstract Background The association between migraine and stroke remains unclear. The aim of this large population-based 15-year follow-up study was to investigate whether primary headache disorders, including subtypes of migraine, increase the risk of stroke. Methods This population-based 15-year follow-up study used baseline headache data from the third Trøndelag Health Study (HUNT3) performed between 2006 and 2008. The HUNT3 headache data were linked to the Norwegian National Stroke Register that includes stroke diagnoses recorded from 2012 until December 2021. The association between stroke and headache status was investigated in individuals aged ≥ 20 years without stroke at baseline. Prospective associations were evaluated using multivariable Cox proportional hazard models with 95% confidence intervals (CIs). Separate sub-group analyses by age and sex were performed. Results Among 37,364 included participants, 1,095 (2.9%) developed stroke, whereof 13.4% were younger than 55 years. In the multi-adjusted model, reporting migraine with aura (MA) at baseline was associated with increased risk of stroke at follow-up (HR 1.55, 95% CI 1.16–2.08) compared with those without headache. The increased risk of stroke was most evident among individuals with MA who were less than 55 years old (HR 1.98, 95% CI 1.20–3.27) and among women (HR 1.64, 95% CI 1.12–2.41). Conclusions During 15 years of follow-up, individuals with MA were more likely to suffer from stroke compared to those without headache. The relationship with MA was even stronger in women, and for young individuals aged < 55 years.