偏头痛会增加抽菸者的中风风险


  【24drs.com】新研究显示,偏头痛与抽菸者的中风风险增加有关,非抽菸者则无。
  
  这些来自人口基础多种族世代中风发生率研究的结果,在线登载于7月22日神经学期刊,作者是佛罗里达州迈阿密大学医学院头痛小组主任、临床神经学助理教授Teshamae S. Monteith医师等人。
  
  研究对象是1,292名40岁以上的人(平均年龄68岁),20% (n = 262人)有偏头痛,平均11年的追踪期间内,偏头痛(有先兆或没有先兆)与中风或其它血管事件之间并无整体关系,不过,198名目前有抽菸习惯者中,18%(n = 35人)有偏头痛者的中风发生率增加3倍。
  
  Monteith医师表示,这些研究结果有点令人惊讶,我们发现偏头痛和传统血管风险因素之间的关联,还发现偏头痛和中风/心血管事件的关联。
  
  她表示,需要后续研究,以确认抽菸偏头痛患者之中风风险增加的生物机转;但在此期间,已知偏头痛与血管风险因素增加有关,偏头痛患者应该知道,如果他们有抽菸,则会面临中风风险增加的情况,但戒菸永远不嫌迟。
  
  新罕布夏Lebanon Dartmouth学院Geisel医学院神经科教授Thomas N. Ward医师受邀对这些研究结果发表评论时表示,这篇研究确认抽菸与偏头痛是不好的组合,而且,如果病患有使用外源性雌激素时,情况会更糟糕。
  
  至于偏头痛和中风之间缺乏整体关联,Ward医师表示,相较于比较中风和心脏病发作风险与偏头痛关联之其它研究,这篇研究相对较小且只有年长族群,因此,它可能无法发现大型研究才能察觉的一些比较小的征兆。
  
  偏头痛者比较可能有高血压(81% vs. 73%;P = .0094)与高胆固醇血症(68% vs. 60%;P = .0184),且比较不会进行中等到繁重的运动(4% vs 8%;P = .0215)。
  
  在平均追踪11年间,有114例中风、94例心肌梗塞、178例血管原因死亡。
  
  控制社经与血险风险因素之后,有偏头痛者相较于无偏头痛者的中风风险比,目前有抽菸者为3.17、以前有抽菸者为0.87、未曾抽菸者为0.49;若合并血管事件,有偏头痛者相较于无偏头痛者的风险比,目前有抽菸者为1.83、目前无抽菸者为0.63。
  
  Monteith 医师表示,有趣的是,我们这些有偏头痛但没有抽菸的世代中,比较少有血管事件;还不清楚这是这些没抽菸偏头痛患者有比较健康生活型态的结果,还是因为报告时的偏差。
  
  Ward医师指出,以前的研究显示,相较于无偏头痛者,偏头痛患者比较可能会抽菸,但是比较不会喝酒。他表示,这篇研究的作者们充分说明了他们的研究限制,或许是因此而得到略有不同的研究结果。
  
  资料来源:http://www.24drs.com/
  
  Native link:Migraine Ups Stroke Risk, but Only in Smokers

Migraine Ups Stroke Risk, but Only in Smokers

By Miriam E. Tucker
Medscape Medical News

Migraine is associated with an increased risk for stroke among active smokers, but not nonsmokers, new research shows.

The findings, from a population-based multiethnic cohort study of stroke incidence, were published online July 22 in Neurology by Teshamae S. Monteith, MD, assistant professor of clinical neurology and chief of the Headache Division at the University of Miami's Miller School of Medicine, Florida, and colleagues.

Among the 1292 participants older than 40 years (mean age, 68 years), including 20% (n = 262) with migraine, there was no overall relationship between migraine (with or without aura) and stroke or other vascular events at an average of 11 years' follow up. However, among the 198 current smokers, the 18% with migraine (n = 35) had a 3-fold increased risk for stroke.

The findings were somewhat surprising, Dr Monteith told Medscape Medical News. "We found a relationship with migraine and traditional vascular risk factors but also expected to see an association between migraine and stroke/cardiovascular events."

Further work is needed to determine the biological mechanisms underlying the increased risk for stroke in patients with migraine who smoke, she said. But in the meantime, "Already, migraine is associated with increased vascular risk factors. Migraineurs should be aware that they place themselves at a greater risk for stroke and combined vascular events if they smoke. It is never too late to quit smoking."

Asked to comment on the findings, Thomas N. Ward, MD, professor of neurology at the Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire, said that the study "does confirm that smoking and migraine is a bad combination, and already known to be even worse if the patient is taking exogenous estrogen."

As for the lack of overall relationship between migraine and stroke, Dr Ward said, "Compared to some of the other studies relating stroke and heart attack risk to migraine this was a relatively small study with an older population. It therefore may not have been able to detect the abnormality where some of the very large studies may have found the presumably smaller signal."

Those with migraine were more likely to have hypertension (81% vs. 73%; P = .0094) and hypercholesterolemia (68% vs. 60%; P = .0184) and were also less likely to engage in moderate to heavy physical activity (4% vs 8%; P = .0215).

Over the mean of 11 years, there were 114 strokes, 94 myocardial infarctions, and 178 vascular deaths.

The hazard ratios for stroke for migraine vs no migraine were 3.17 among current smokers, 0.87 in former smokers, and 0.49 in those who never smoked (after controlling for socioeconomic and vascular risk factors). For combined vascular events, the hazard ratios for migraine vs no migraine were 1.83 among current smokers and 0.63 among current nonsmokers.

"Interestingly, our cohort of nonsmokers with migraines appeared to have fewer vascular events. It was not clear if this was a consequence of healthier lifestyles of nonsmoking migraine subjects or due to reporting biases," Dr Monteith told Medscape Medical News.

Previous studies have shown that migraineurs are more likely to smoke but less likely to drink alcohol than nonmigraineurs, Dr Ward pointed out.

"The authors in this study do a nice job of addressing the limitations of their study and perhaps why the findings are a bit different," he said.

This study was funded by the National Institute of Neurological Disorders and Stroke. The authors have disclosed no relevant financial relationships. Dr Ward is the editor-in-chief of the American Headache Society's journal Headache. He has disclosed no relevant financial relationships.

Neurology. Published online July 22, 2015.

    
相关报导
暂时性脑缺血发作的专门单位与极低的事件比率有关
2016/5/6 上午 09:47:01
不晒太阳的风险和抽菸一样
2016/4/1 上午 10:21:38
偏头痛与肠躁症有关
2016/3/10 下午 01:22:23

上一页
   1   2   3   4   5   6   7   8   9   10  




回上一页