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Background <p>To evaluate whether menopausal status modifies the association between migraine and cardiovascular disease (CVD) risk in women, using both relative and absolute risk measures.</p> Methods <p>We conducted a nationwide cohort study using Korean National Health Insurance Service data. Women aged ≥ 40 years who underwent the 2009 health screening and had no prior CVD (myocardial infarction or stroke) were included. Migraine was defined by using ICD-10 diagnostic codes. Menopausal status was determined from questionnaire-based reproductive history and prespecified as an effect modifier. Incident CVD and cardiovascular death were ascertained. Multivariable Cox models were used to estimate hazard ratios (HRs).</p> Results <p>Among 2,156,733 women, 923,517 were premenopausal and 1,233,216 postmenopausal. In premenopausal women, CVD incidence was higher in those with migraine than in those without migraine (2.22 vs. 1.38 per 1,000 person-years), with a higher risk after multivariable adjustment (HR 1.53, 95% CI 1.42–1.66). In postmenopausal women, CVD incidence was also higher among those with migraine (9.53 vs. 7.50 per 1,000 person-years), although the relative association was attenuated but remained significant (HR 1.20, 95% CI 1.17–1.23). Accordingly, the crude incidence rate difference associated with migraine was larger after menopause (2.03 vs. 0.84 per 1,000 person-years). The relative associations between migraine and cardiovascular outcomes were stronger in premenopausal women, whereas larger absolute risk differences were observed in postmenopausal women. This pattern was observed for CVD, myocardial infarction, and ischemic stroke, but not for cardiovascular death.</p> Conclusion <p>Migraine was associated with increased CVD risk in women. Relative associations were stronger before menopause, whereas absolute excess incidence was greater after menopause. These findings highlight the importance of considering migraine in cardiovascular risk assessment across the female life course, including after menopause.</p>

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Menopausal status modifies the association between migraine and cardiovascular disease risk: a nationwide cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Do Yeon Kim,
  • Kyungdo Han,
  • Jeen Hwa Lee,
  • Sangwon Choi,
  • Ye Seul Yang,
  • Jeong-Yoon Lee,
  • Jonguk Kim,
  • Dae Young Cheon,
  • Minwoo Lee

摘要

Background

To evaluate whether menopausal status modifies the association between migraine and cardiovascular disease (CVD) risk in women, using both relative and absolute risk measures.

Methods

We conducted a nationwide cohort study using Korean National Health Insurance Service data. Women aged ≥ 40 years who underwent the 2009 health screening and had no prior CVD (myocardial infarction or stroke) were included. Migraine was defined by using ICD-10 diagnostic codes. Menopausal status was determined from questionnaire-based reproductive history and prespecified as an effect modifier. Incident CVD and cardiovascular death were ascertained. Multivariable Cox models were used to estimate hazard ratios (HRs).

Results

Among 2,156,733 women, 923,517 were premenopausal and 1,233,216 postmenopausal. In premenopausal women, CVD incidence was higher in those with migraine than in those without migraine (2.22 vs. 1.38 per 1,000 person-years), with a higher risk after multivariable adjustment (HR 1.53, 95% CI 1.42–1.66). In postmenopausal women, CVD incidence was also higher among those with migraine (9.53 vs. 7.50 per 1,000 person-years), although the relative association was attenuated but remained significant (HR 1.20, 95% CI 1.17–1.23). Accordingly, the crude incidence rate difference associated with migraine was larger after menopause (2.03 vs. 0.84 per 1,000 person-years). The relative associations between migraine and cardiovascular outcomes were stronger in premenopausal women, whereas larger absolute risk differences were observed in postmenopausal women. This pattern was observed for CVD, myocardial infarction, and ischemic stroke, but not for cardiovascular death.

Conclusion

Migraine was associated with increased CVD risk in women. Relative associations were stronger before menopause, whereas absolute excess incidence was greater after menopause. These findings highlight the importance of considering migraine in cardiovascular risk assessment across the female life course, including after menopause.