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The association between migraine and coronary heart disease (CHD) is important for at least two reasons. As a common disorder of early and middle adult life, if migraine were a risk factor for CHD, it could account for a high proportion of CHD in these age groups. Second, because currently available migraine-specific medications constrict coronary arteries, if patients with migraine were at risk for CHD, greater caution in selecting patients for triptans might be warranted.
The relationship between headaches in general and migraine in particular with the risk of CHD has been debated for many years. Case reports and clinical data suggest an association between angina, especially variant angina, and migraine. Epidemiologic studies have produced conflicting results. Two large investigations with cohort design and with diagnosis of CHD verified through medical records have been published. In the Kaiser Permanente study in Northern California, a retrospective cohort of ∼80,000 subjects showed that migraine was associated with self-reported chest pain but was not associated with an increased risk of myocardial infarction (MI) with the exception of women who had both a diagnosis …
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