The study results should not make women with migraine headaches fearful, Kurth said. "Despite a very large study group, only a few participants who had migraine actually had a stroke," he said. "Only a very few people who had migraine with aura eventually have a stroke."
There is no clear explanation for the difference between risk of stroke and risk of heart attack in the migraine group, Kurth said. "The clinical application at the moment is unclear," he said. "It is unclear whether changing migraine frequency would affect cardiovascular events. At this point it is a research finding without much patient or clinical application."
Dr. Cheryl D. Bushnell, associate professor of neurology at Wake Forest University Health Sciences in North Carolina, said she agrees. "I don't think this is the kind of paper that can be presented to a patient and provide counseling," she said.
She anticipates updates on the relationships. "They have more events now than they did in the first report, and there could be some fluctuations that could occur as they continue to gather events," she said.
The data on the relationship with less-frequent migraines is not as solid as it might be, said Dr. Richard Lipton, director of the Montefiore Headache Center in New York City. "The confidence intervals are very broad for that group, but the results are unequivocal for the high-frequency group," Lipton said. "My inclination is that the figure for the once-a-month group is a blip, and the real finding is an overall risk associated with frequent migraines."
Lipton added, "All we have now is observational data on migraine. The sort of data I would love to see would be to give preventive medicine and see if it is associated
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