Photo by author. All rights reserved.

Photo by author. All rights reserved.

By Karen Roush, MS, RN, FNP, clinical managing editor

I used to think I was lucky. Most of the women in my family have migraines—awful, vomiting for three days, intense pain migraines. Not me. Oh, I have migraines. But no pain, no vomiting, just a visual aura—squiggly lines and loss of part of my visual field for about 45 minutes and then I’m good to go.

I was thankful that I just had the aura instead of the pain and vomiting. But now the evidence shows that migraine with aura, especially when there is no vomiting involved, is an independent risk factor for stroke, as much as if I were overweight, smoking cigarettes, and walking around with my blood pressure through the roof.

And it’s not just having migraines that places me at greater risk for a stroke. Just being a woman is enough to do that. Last week, the American Heart Association/American Stroke Association issued the first ever stroke guidelines specifically for women (pdf), in response to growing evidence that women of all ages have more strokes, have strokes at a younger age, and have worse outcomes after stroke than men. And since there are more “women of a certain age” compared to men, these factors are about to create a greater “burden,” as they say, on the health care system.

There are some things women can do to mitigate their risk. Addressing modifiable risk factors is number one, of course—smoking and obesity, for example. Consider alternate forms of birth control if you’re on oral contraceptive pills and be diligent about managing hypertension. As for migraines—though it appears that risk increases along with the frequency of migraines, research hasn’t established if taking migraine preventatives lowers that risk.