For analysis, only individuals without any headache history were included as controls.Ī headache questionnaire was administered to all participants who attended ARIC visit 3. A total of 12,758 participants fulfilled our criteria and were included for analysis. We excluded participants with first ischemic stroke event that occurred before the third clinical visit in the ARIC study (1993–1995) (n = 87) and participants with missing headache information (n = 37). In the current study, we included all participants who completed the third clinic visit (1993–1995) in ARIC (n = 12,882). Hospital medical records are obtained for all vascular hospitalizations, including stroke. 15 In addition, participants are contacted annually by telephone, and queried about any hospitalizations. Vascular risk factors and markers as well as various health interviews were completed at each visit, and participants underwent laboratory testing at each visit. Surviving participants completed visit 5 during 2011–2013. Baseline information was collected at the first visit from 1987 to 1989, and follow-up visits every 3 years for visits 2 (1990–1992), 3 (1993–1995), and 4 (1996–1998) were completed. 15 The study enrolled 15,792 participants within the age group of 45–64 years in 4 different US communities (Forsyth County, North Carolina Jackson, Mississippi suburbs of Minneapolis, Minnesota and Washington County, Maryland). The cohort of the ARIC study was initiated in 1987 with an aim of studying the causes of atherosclerosis and clinical sequelae. While other studies have examined the relationship between migraine and stroke, we specifically aimed to examine the association between ischemic stroke subtypes, including thrombotic, cardioembolic, and lacunar strokes, and migraine with and without aura. 10, – 14 In the Atherosclerosis Risk in Communities (ARIC) study, we proposed to evaluate the association between migraine with and without aura and ischemic stroke and to expand on prior work in ARIC and in other studies. Furthermore, there are still controversial reports on relationship between migraine without aura and ischemic stroke this may be due to variations in study populations across prior published studies. Investigation of stroke subtypes and association with migraine may shed light on the potential mechanism. 8, 9 However, there is a paucity of data on the pathogenesis of increased risk of ischemic stroke in migraine with aura.
7 Furthermore, subclinical infarcts have been linked to migraine. 1, – 6 A recent review on migraine and stroke presented substantial neuroimaging and genetic evidence supporting the link between migraine with aura and ischemic stroke. Epidemiologic studies have demonstrated that migraine with aura is associated with increased risk of ischemic stroke.
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