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ARTICLES: A. I. Scher, G. M. Terwindt, H. S.J. Picavet, W. M.M. Verschuren, M. D. Ferrari, and L. J. Launer Cardiovascular risk factors and migraine: The GEM population-based study Neurology 2005; 64: 614-620 [Abstract] [Full text] [PDF]

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Reply to Ikeda et al

Ann I Scher, Lenore J. Launer   (10 May 2005)

Cardiovascular risk factors and migraine: The GEM population-based study

Ken Ikeda, Hidetoshi Kashihara, Ken-ichi Hosozawa, Yoshinori Maruyama, Masaki Tamura, Yasuo Iwasaki   (10 May 2005)

Reply to Ikeda et al 10 May 2005
Ann I Scher, Uniformed Services University of the Health Sciences 4301 Jones Bridge Road; Bethesda, MD 20814-4799, Lenore J. Launer Send Correspondence to journal: Re: Reply to Ikeda et al ascher{at}usuhs.mil Ann I Scher, et al.	We thank Dr. Ikeda et al for sharing the results from their large MRI sample and for their interest in our study. In their study, the prevalence of cardiovascular risk factors did not differ between controls and migraineurs overall or between migraineurs with and without aura. Their results are discrepant with our findings. We found that the migraineurs, particularly those with aura, were more likely to have CVD risk factors compared to non-migraineurs. Results may be affected by demographic differences between the GEM and Brain Check-Up (BC) study participants. The GEM sample was from the general population and the BC sample was recruited from a primarily employed sample who had sought medical care. Underlying population differences in the rates of cardiovascular disease and baseline cardiovascular risk profiles in Japan and the Netherlands may also be important. An “eyeball” comparison of the CVD risk factor profiles between the Japanese and Dutch control groups shows considerable differences in baseline risk factors including obesity (BC study: 25% vs. GEM 12%), hypercholesterolemia (30% vs 16%), current smoking (23% vs. 34%), and current use of oral contraceptives (4% vs. 23%). The average age of the two control groups was roughly similar, although the BC controls had a higher proportion of women (59% vs. 49%). We look forward to comparing our results from those based on other migraine cohorts, as this may lead to new hypotheses about the development and prevention of migraine.
Cardiovascular risk factors and migraine: The GEM population-based study 10 May 2005
Ken Ikeda, Department of Neurology, PL Tokyo Health Care Center 16-1, Kamiyamacho, Shibuyaku, Tokyo, 150-0047, Japan, Hidetoshi Kashihara, Ken-ichi Hosozawa, Yoshinori Maruyama, Masaki Tamura, Yasuo Iwasaki Send Correspondence to journal: Re: Cardiovascular risk factors and migraine: The GEM population-based study keni{at}pl-tokyo-kenkan.gr.jp Ken Ikeda, et al.	We read with great interest the article by Scher et al [1] concerning cardiovascular risk factors and migraine. We would like to compare between the results of Scher et al [1] and our re-analysis of migraine subtypes in previous migraine study applied a protocol of brain check- up. [2] Cardiovascular risk factors were assessed in 357 migraineurs (50 with MA and 307 with MO) and 356 non- migraineurs. Frequency of obesity, current smoke, hypertension, diabetes mellitus and hypercholesterolemia did not differ significantly among the four groups. Compared to GEM population of Scher et al [1], a percentage of low socioeconomic status (SES) and oral contraceptive use was lower in our subjects (table). A parental history of migraine showed a predisposion to MA. MA and MO were not associated with a parental history of early coronary heart disease or stroke. Clinical hallmark of our migraineurs revealed a higher ratio of MO sufferers who had mild degree of headache severity. MA sufferers included 28 subjects (56%) younger than age 39 years. [2] We would like to know Scher et al's results regarding severity and frequency of migraine attacks, and also comparative data of the risk profile between MA sufferers and non-migraineurs at age 39 years or younger. Scher et al [1] do indicate statistical date adjusted for sex, age, SES and all cardiovascular risk factors. Brain MRI studies also differ between a subset of the GEM sample [3] and our migraineurs. [2] Those contrary results of cardiovascular risk factors and brain lesions strongly suggest an importance of migraine studies in various populations with regard to education level, race and country. Table References 1. Scher AI, Terwindt GM, Picavet HSJ, Verschuren WMM, Ferrari MD, Launer LJ. Cardiovascular risk factors and migraine: the GEM population-based study. Neurology 2005; 64: 614-620. 2. Ikeda K, Kashihara H, Hosozawa K, et al. Brain check-up- based study of migraine in Japan. Headache Care 2005; 2: 75-80. 3. Kruit MC, van Buchem MA, Hofman PA, et al. Migraine as a risk factor for subclinical brain lesions. JAMA 2004; 291: 427-434.