Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Chronic Health Conditions in Patients with Migraine

Relationships were observed between migraine or severe headache and chronic health conditions in a recent cross-sectional study of US adults. Researchers used data collected from the 2013-2015 National Health Interview Survey to examine adults with and without migraine or severe headache, and associations with chronic obstructive pulmonary disease (COPD), cancer, heart disease, stroke, diabetes, and hypertension. They found:

  • The study included 104,926 individuals.
  • Adults aged 18-44 years, women, and those with some college education had the greatest proportion with migraine or severe headache.
  • Adults reporting migraine had increased odds of reporting a single chronic health conditions and more than double to odds of reporting ≥2 chronic health conditions compared to adults who did not have migraine or severe headache.


Minen MT, et al. The relationship between migraine or severe headache and chronic health conditions: A cross-sectional study from the National Health Interview Survey 2013-2015. [Published online ahead of print May 25, 2019]. Pain Med. doi:10.1093/pm/pnz113.


This monograph adds to the migraine epidemiologic literature by virtue of data base size. The authors call attention to the significant migraine-stroke association, noting in “the Women’s Health Study, a prospective cohort study of >27,000 US women, enrolled at age >45 years, association between migraine with aura and ischemic stroke was apparent only among women with the lowest Framingham risk scores, including with low rather than elevated blood pressure” (Kurth et al. BMJ 2008;337:a636). They suggest that the migraine-stroke interaction may not be atherosclerotic, although migraine is associated with significant endothelial pathology. The investigators also found a migraine-heart disease association but point out that in the same Kurth et al. study, migraine with aura was associated with increased angina risk for women with both low and high Framingham risk scores, but association with myocardial infarctions only in those with high Framingham risk scores, so there is much pathophysiology as yet unexplained on these interactions. —Stewart J. Tepper, MD, FAHS, Professor of Neurology, Geisel School of Medicine at Dartmouth, Director, Dartmouth Headache Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH