The association between migraine and SCORE2 - a Swedish cross-sectional study

Migraine affects more than one billion people globally and is associated with higher cardiovascular risk. In clinical practice in Europe, cardiovascular risk is often assessed with SCORE2, to identify patients who need preventive care. This study aims to explore the potential association between a register-based diagnosis of migraine and SCORE2 in a cross-sectional study of 40- and 50-year-old people screened for unhealthy lifestyle habits and cardiovascular risk, in Sweden.

A cross-sectional study was performed with data from a cardiovascular screening program, called Targeted Health Dialogues, which included questionnaires, blood pressure measurements and blood samples. Diagnoses of migraine were collected from a regional patient register, from year 2000 and ahead. Firth's penalized logistic regression was used to calculate odds ratios (ORs) for moderate/high SCORE2 dependent on diagnosis of migraine. The regressions were stratified by sex and stepwise adjusted for age, level of education and country of birth. Multivariable linear regression models with SCORE2 as a continuous variable were also used to assess the association.

Of the 9 190 participants, 875 (9.5%) had a diagnosis of migraine. In 628 cases (72%) it was not possible to distinguish between migraine with and without aura; therefore, these groups were analyzed together. The unadjusted ORs for having a moderate SCORE2 was 0.60 (0.22-1.32) for women with migraine and 1.13 (0.80-1.58) for men with migraine. Adjustments led to almost unaltered results.

In this cross-sectional cohort, the OR of medium/high SCORE2 was not significantly different between individuals with and without a register-based diagnosis of migraine. However, this study could not rule out an existing association. Future studies should include samples that allow for separate analyses of current and past migraine as well as migraine with and without aura.