From Headache to Heart Health: Investigating the Migraine-Cardiovascular Disease Connection

Area of Science:

• Neurology
• Cardiology
• Psychiatry

Background:

• Migraine, particularly with aura, is associated with increased cardiovascular disease (CVD) risk, including ischemic stroke and myocardial infarction.
• Shared pathophysiological mechanisms like endothelial dysfunction, platelet aggregation, systemic inflammation, and autonomic imbalance suggest migraine as a marker of vascular vulnerability.
• Psychiatric comorbidities in chronic migraine exacerbate disability and may increase long-term cardiovascular risk.

Purpose of the Study:

• To review the evolving understanding of migraine as a multisystem disorder.
• To emphasize the vascular and neuropsychiatric dimensions of migraine.
• To discuss the role of calcitonin gene-related peptide (CGRP)-targeting monoclonal antibodies in managing migraine and associated comorbidities.

Main Methods:

• This is a narrative review.
• It synthesizes current research on the links between migraine, cardiovascular health, and psychiatric conditions.
• It examines emerging data on CGRP-targeting therapies.

Main Results:

• Migraine may serve as an early clinical indicator of systemic vascular vulnerability.
• CGRP-targeting monoclonal antibodies are effective in reducing headache frequency.
• These therapies demonstrate a favorable cardiovascular safety profile and may improve mood symptoms in patients with comorbid depression and anxiety.

Conclusions:

• Migraine is a complex condition with interconnected neurological, cardiovascular, and psychiatric pathways.
• Recognizing these connections can aid in earlier risk stratification for cardiovascular events.
• Integrated treatment approaches are crucial for managing patients with complex migraine presentations and comorbidities.