High diastolic blood pressure linked to 16% higher migraine risk in women

• A new study of more than 7,000 men and women found a slightly higher risk of developing migraine in women with high blood pressure.
• Many studies have been done examining the role of migraine in strokes, heart attacks, and heart disease, but few have looked at the reverse effect.
• Women in general are more susceptible to the development of migraine than men, but experts say more studies are needed to examine any concrete links between cardiovascular health and migraine.

High blood pressure — specifically high diastolic pressure, when the heart is resting between beats — was linked to a slightly higher risk of migraine in women, says a new study funded by the Dutch Research Council and recently published in Neurology .

According to study author Antoinette Maassen van den Brink, PhD , of Erasmus MC University Medical Center in Rotterdam, the Netherlands, plenty of research exists about how migraine is linked to cardiovascular events like strokes, heart attack, and heart disease.

However, to date there has not been as much investigation into how cardiovascular health is linked to developing migraine.

Women with high blood pressure more likely to develop migraine

The recent study, which involved 7,266 men and women with a median age of 67, examined how smoking, obesity, high cholesterol, and cardiovascular disease like diabetes might be connected to the development of migraine.

Fifteen percent of the participants had previous or current migraine. All participants provided blood samples and were given physical exams.

After adjusting for various risk factors and education levels, researchers found that women with a higher diastolic blood pressure were 16% more likely to develop migraine.

No connections between migraines and cardiovascular issues were found in the study’s male participants.

There was no connection to systolic blood pressure, which is the maximum pressure in arteries during heartbeats. Blood pressure is measured as systolic over diastolic.

Maassen van den Brink suggested this was consistent with the idea that a constriction of the small blood vessels is more associated with migraine than any reduced function of larger blood vessels.

Steven Allder, MD , consultant neurologist at Re:Cognition Health, who was not involved in this research, told Medical News Today that the study does indeed back up this concept.

“The theory that migraines are associated with reduced function in small blood vessels is supported by this study, which found a link between higher diastolic blood pressure — related to small vessel function — and migraines,” Allder said.

“This contrasts with the lack of association found with systolic blood pressure, which is more indicative of large vessel function. This theory aligns with other research suggesting that migraines involve changes in the microvasculature of the brain.”

– Steven Allder, MD

How strong is the connection between blood pressure and migraine?

Cheng-Han Chen, MD , a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, who was not involved in the study, told MNT that ultimately more research is needed to determine any connections between cardiovascular health and migraine.

“This study examined the relationship between multiple cardiovascular risk factors and the development of migraines but did not find any clear association,“ he explained. “This would suggest that traditional cardiovascular risk factors do not contribute to migraines, as previously speculated.“

“While this study found a specific association between elevated diastolic blood pressure and migraines in women, the data as a whole do not support a solid connection between blood pressure and migraines,” cautioned Chen.

“While previous studies have linked migraines with the development of cardiovascular disease, for now the connection between cardiovascular risk factors and migraines remains unclear,” he pointed out.

How is the development of migraines linked to biological sex?

A paper published in Neurological Sciences in 2022 cited global migraine prevalence as 20.7% in females and 9.7% in males, stating that hormonal differences in addition to “differences in brain structure, genetic polymorphisms and neuronal pathways” might explain the disparity.

According to Maassen van den Brink, the absence of any connection between cardiovascular risks and the development of migraine in men was due to the lower number of male participants in the study.

She added that studies of younger people might help establish any further gender-based discrepancies.

Chen and Allder both noted that the smaller prevalence of migraine in men overall.

“One possible reason is hormonal differences that might influence both blood pressure regulation and migraine occurrence,” Allder suggested. “The smaller number of male participants with migraines might [also] have limited the ability to detect associations in men.“

“Gender differences in lifestyle, behaviour and response to cardiovascular risk factors could also play a role,” he further noted.

Chen shared a similar view, suggesting that:

“It is possible that the disparity in results between genders is related to the lower overall prevalence of migraines in men, making the study underpowered to detect a potential association. It is also possible that sex hormones underlie the pathophysiological mechanisms behind migraines, resulting in a difference in prevalence between genders.”

“The theory that small blood vessel/microvascular dysfunction is related to the development of migraines would be supported by this finding of a link between elevated diastolic pressure and migraines in women,” said Chen.

“However, much more research would be necessary to elucidate the mechanism behind such a connection,” he cautioned.