女性の片頭痛と心血管疾患のリスク
Tobias Kurth1, J Michael Gaziano, Nancy R Cook
1Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02215-1204, USA. tkurth@rics.bwh.harvard.edu
JAMA
|July 20, 2006
まとめ
オーラ付きの片頭痛は,心臓発作や脳卒中を含む女性における心血管疾患のリスクを大幅に増加させます. オーラのない片頭痛は,これらのリスクを高めるようには見えません.
科学分野:
- 心臓病学 心臓病学
- 神経学 神経学とは
- エピデミオロジー エピデミオロジー
背景:
- オーラ付きの頭痛は,心臓血管リスク因子の低下と前血栓性状態に関連しています.
- 缺血性脳卒中に関連しているが,より広範な心血管疾患 (CVD) と冠動脈イベントとの関連は完全に理解されていない.
研究 の 目的:
- オーラとオーラなしの片頭痛と,その後の総合的および特定のCVDのリスクとの関連性を調査する.
- 女性の異なるタイプの片頭痛と心血管疾患との関係を明らかにする.
主な方法:
- 女性健康研究から,45歳以上の米国女性27,840人を対象とした前向きなコホート研究.
- フォローアップデータは平均10年にわたって収集され,主要なCVDイベント,不全性脳卒中,心筋梗塞,冠動脈再血管化,および胸痛を評価しました.
主要な成果:
- オーラのある活発な片頭痛を有する女性は,主要なCVD (HR 2.15),不全性脳卒中 (HR 1.91),心筋梗塞 (HR 2.08),および冠動脈再循環 (HR 1.74) のリスクが著しく増加しました.
- 1年に1万人の女性につき18件の主要なCVDイベントが,オーラ付きの片頭痛に起因していた.
- オーラのない活発な片頭痛を持つ女性では,血管イベントのリスクの増加は観察されなかった.
結論:
- オーラ付きのアクティブ・ミグレインは,心筋梗塞と不全性脳卒中を含む主要な心血管疾患のリスクが著しく上昇する.
- この発見は,心臓血管リスク評価に関して,片頭痛患者のオーラ状態を考慮することの重要性を強調しています.
- このコホートでは,オーラのない片頭痛は,心血管疾患のリスクの増加と有意な関連性を示さなかった.
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