Researchers recommended routine blood pressure checks in adolescents with migraine.
Young people with migraine have triple the odds of developing high blood pressure and should be closely monitored for hypertension, researchers say.
The findings suggest that migraine in young people may be a clinical marker of future vascular risk and individuals may benefit from early detection and management, the researchers said.
The study used data of more than two million Israeli adolescents aged 16 to 20 years who were screened for military service over a 30-year period.
All recruits were screened for hypertension, and migraine diagnoses were based on examinations by neurologists.
The researchers found that 2.85% of participants had a diagnosis of migraine, and among those, 0.7% were diagnosed with hypertension compared with 0.2% of those without migraine.
That equates to a three-fold increase in odds for the diagnosis of hypertension among individuals with migraine, the researchers said in Hypertension.
The association was stronger in adolescents with severe migraine and hypertension, according to the research, led by Dr Inbal Akavian from the Department of Military Medicine and the Faculty of Medicine at Hadassa-Hebrew University.
The findings suggest that young people with migraines should be closely monitored for hypertension, said co-author and public health physician Professor Ronit Calderon-Margalit from the Faculty of Medicine at Hebrew University.
“Our findings indicate at least a co-occurrence, if not a causal, relationship between migraines and hypertension in young adults,” Professor Calderon-Margalit told The Medical Republic.
“Therefore, primary care physicians should be vigilant for hypertension in young adults who present with migraines.
“Routine blood pressure measurements in patients with migraines seem advisable, as early identification of hypertension and other vascular risk factors may help reduce adverse outcomes, and the associated morbidity and mortality.”
Professor Calderon-Margalit said the study was observational and cross sectional, which limited their ability to infer the effectiveness of treatments at any stage of increased blood pressure.
But there were some hypotheses regarding the potential mechanism, including a shared genetic basis for both diseases, Professor Calderon-Margalit said.
“In addition, there could be hormonal basis, specifically fluctuations on estrogen levels in women that affect both vascular function and the incidence of migraines.”
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The researchers said other possible mechanisms linking migraine and hypertension were endothelial dysfunction and vascular reactivity.
The researchers also found that the association between migraine and hypertension was stronger in female participants.
“A biological mechanism may contribute to this finding, as estrogen fluctuations are known to influence migraine pathophysiology, and hormonal changes may affect vascular function.
“Migraine severity and disability also tend to be greater in women, and in our cohort, high-severity migraine was associated with higher odds of hypertension, supporting a role for migraine burden in modulating this association.”
The researchers said the age of participants corresponded to the peak incidence of migraine in boys – 15 to 19 years – and preceded the peak in women – 20 to 24 years.
Previous studies on the association between migraine and hypertension included a broader age range and focussed on middle-aged or older adults, they said, but migraine prevalence dropped in older people despite a rise in hypertension prevalence.
“This emphasises the need for data on the association in earlier ages, when migraine incidence is at its peak and hypertension may begin to emerge, yet early detection could help prevent long-term cardiovascular complications.”
The researchers said their analysis of high-severity migraine found a stronger association than that for all migraine cases.
“Moreover, in an additional sensitivity analysis, the odds for severe hypertension were higher than for low-severity hypertension in migraineurs.
“These sub-analyses support dose-response relationships, indicating that as migraine severity increases, there is a corresponding increase in the odds of hypertension and severe hypertension.”
