Arterial hypertension in migraine: Role of familial history and cardiovascular phenotype

Published:January 24, 2017DOI:


      • Autonomic regulation in migraine patients with/without hypertension was compared with healthy subjects matched by age/sex.
      • Migrainers with hypertension have reduced arterial baroreflex but parameters of cardiac autonomic regulation were unchanged.
      • Increased vasomotor reactivity in migrainers with or without hypertension was associated with the family history of cardiovascular diseases.


      Recent studies indicate that migraine is associated with increased risk of cardiovascular diseases. However, links between autonomic cardiovascular regulation, arterial hypertension (AH) and migraine are still little explored. In this study, we evaluated autonomic regulation in migraine patients with and without hypertension. We studied 104 patients with migraine, aged 34 ± 10 y, including 28 with and 76 without hypertension (M + AH and M − AH groups, respectively). The control group consisted of 88 healthy volunteers matched by age and sex. The autonomic regulation of circulation was examined with the tilt-table test, deep-breathing and Valsalva Maneuver, handgrip test, cold-stress induced vasoconstriction, arterial baroreflex, and blood pressure variability measurements. We found that migraine patients with concomitant hypertension demonstrated reduced arterial baroreflex, whereas other parameters of cardiac autonomic regulation were unchanged. In contrast, most indicators of vasomotor reactivity (blood pressure response to the hand-grip, Valsalva maneuver and cold vasoconstriction) were enhanced in migraine patients with no significant differences between migraine patients with and without hypertension. Patients from both M + AH and M − AH groups more commonly had a family history of cardiovascular disorders. Our data revealed increased vasomotor reactivity in migraine patients, with or without concomitant hypertension. This was associated with the family history of cardiovascular diseases.


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        • Andruce B.
        • Lacaille D.
        2013 ACC/AHA guideline on the assessment of cardiovascular risk.
        J Am Coll Cardiol. 2014; 63: 2886
        • Cortelli P.
        • Pierangeli G.
        • Parchi P.
        • Contin M.
        • Baruzzi A.
        • Lugaresi E.
        Autonomic nervous system function in migraine without Aura.
        Headache. 1991; 31: 457-462
        • de Falco F.A.
        • de Falco A.
        Migraine with aura: which patients are most at risk of stroke?.
        Neurol Sci. 2015; 36: 57-60
        • Etminan M.
        • Takkouche B.
        • Isorna F.C.
        • Samii A.
        Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies.
        Br. Med. J. 2005; 330: 63
        • Ewing D.J.
        • Irving J.B.
        • Kerr F.
        • Wildsmith J.A.W.
        • Clarke B.F.
        Cardiovascular responses to sustained handgrip in normal subjects and in patients with diabetes mellitus: a test of autonomic function.
        Clin Sci. 1974; 46: 295-306
        • Furlan R.
        • Jacob G.
        • Snell M.
        • Robertson D.
        • Porta A.
        • Harris P.
        • Mosqueda-Garcia R.
        Chronic orthostatic intolerance. A disorder with discordant cardiac and vascular sympathetic control circulation.
        98. 1998: 2154-2159
        • Headache Classification Committee of the International Headache Society
        The International Classification of Headache Disorders, 3rd edition (beta version).
        Cephalalgia. 2013; 33: 629-808
        • Honzikova N.
        • Labrova R.
        • Fiser B.
        • Maderova E.
        • Novakova Z.
        • Zavodna E.
        • Semrad B.
        Influence of age, body mass index, and blood pressure on the carotid intima-media thickness in normotensive and hypertensive patients.
        Biomed Tech. 2006; 51: 159-162
        • Imaizumi T.
        • Takeshita A.
        • Makino N.
        • Ashihara T.
        • Yamamoto K.
        • Nakamura M.
        Impaired baroreflex control of vascular resistance and heart rate in acute myocardial infarction.
        Br Heart J. 1984; 52: 418-421
        • Kuo C.-Y.
        • Yen M.-F.
        • Chen L.-S.
        • Fann C.-Y.
        • Chiu Y.-H.
        • Chen H.-H.
        • Pan S.-L.
        Increased risk of hemorrhagic stroke in patients with migraine: a population-based cohort study.
        PLoS ONE. 2013; 8e55253
        • Lipton R.B.
        • Bigal M.E.
        The epidemiology of migraine.
        Am J Med. 2005; 118: 3-10
        • Lu K.
        • Clark J.W.
        • Ghorber F.H.
        • Ware D.L.
        • Bidani A.
        A human cardiopulmonary system model applied to the analysis of the Valsalva maneuver.
        Am J Cardiol. 2001; 281: H2661-H2679
        • Mamontov O.V.
        • Babayan L.
        • Amelin A.V.
        • Giniatullin R.
        • Kamshilin A.A.
        Autonomous control of cardiovascular reactivity in patients with episodic and chronic forms of migraine.
        The Jornal of Headache and Pain. 2016; 17: 52
        • Mancia G.
        • Fagard R.
        • Narkiewicz K.
        • Redon J.
        • Zanchetti A.
        • Böhm M.
        • Christiaens T.
        • Cifkova R.
        • De Backer G.
        • Dominiczak A.
        • Galderisi M.
        • Grobbee D.E.
        • Jaarsma T.
        • Kirchhof P.
        • Kjeldsen S.E.
        • Laurent S.
        • Manolis A.J.
        • Nilsson P.M.
        • Ruilope L.M.
        • Shmieder R.E.
        • Sirnes P.A.
        • Sleight P.
        • Viigimaa M.
        • Waeber B.
        • Zannad F.
        Task Force for the Management of Arterial Hypertension of the European Society of Hypertension and the European Society of Cardiology. 2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension.
        Blood Press. 2014; 23: 3-16
        • Martinez F.
        • Castillo J.
        • Pardo J.
        • Lema M.
        • Noya M.
        Catecholamine levels in plasma and CSF in migraine.
        J Neurol Neurosurg Psychiatry. 1993; 56: 1119-1121
        • Matei D.
        • Constantinescu V.
        • Corciova C.
        • Ignat B.
        • Matei R.
        • Popescu C.D.
        Autonomic impairment in patients with migraine.
        Eur. Rev. Med. Pharmacol. Sci. 2015; 19: 3922-3927
        • Mosek A.
        • Novak V.
        • Opfer-Gerhking T.L.
        • Swanson J.W.
        • Low P.A.
        Autonomic dysfunction in migraineurs.
        Headache. 2002; 39: 108-117
        • Novak P.
        Quantitative autonomic testing.
        J Vis Exp. 2011; 19e2502
        • Palatini P.
        • Julius S.
        The role of cardiac autonomic function in hypertension and cardiovascular disease.
        Curr Hypertens Rep. 2009; 11: 199-205
        • Parati G.
        • Ochoa J.E.
        • Lombardi C.
        • Salvi P.
        • Bilo G.
        Assessment and interpretation of blood pressure variability in a clinical setting.
        Blood Press. 2013; 22: 345-354
        • Parmer R.J.
        • Cervenka J.H.
        • Stone R.A.
        Baroreflex sensitivity and heredity in essential hypertension.
        Circulation. 1992; 85: 407-503
        • Sacco S.
        • Ricci S.
        • Carolei A.
        Migraine and vascular diseases: a review of the evidence and potential implications for management.
        Cephalalgia. 2012; 32: 785-795
        • Scher A.I.
        • Terwindt G.M.
        • Picavet H.S.
        • Verschuren W.M.M.
        • Ferrari M.D.
        • Launer L.J.
        Cardiovascular risk factors and migraine: the GEM population-based study.
        Neurology. 2005; 64: 614-620
        • Schürks M.
        • Rist P.M.
        • Bigal M.E.
        • Buring J.E.
        • Lipton R.B.
        • Kurth T.
        Migraine and cardiovascular disease: systematic review and meta-analysis.
        The British Medical Journal. 2009; 27: b3914
        • Schwaiger J.
        • Kiechl S.
        • Stockner H.
        • Knoflash M.
        • Werner P.
        • Rungger G.
        • Gasperi A.
        • Willeit J.
        Burden of atherosclerosis and risk of venous thromboembolism in patients with migraine.
        Neurology. 2005; 71: 937-943
        • Takato S.
        • Iwase N.
        • Okuwa H.
        • Ogawa J.
        • Ikeda T.
        • Hattori N.
        Baroreflex function and pressor responsiveness in normotensive young subjects with a family history of hypertension.
        Jpn Circ J. 1985; 49: 990-996
        • Tronvik E.
        • Zwart J.-A.
        • Hagen K.
        • Dyb G.
        • Holmen T.L.
        • Stovner J.
        Association between blood pressure measures and recurrent headache in adolescents: cross-sectional data from the HUNT-Youth study.
        J. Headache Pain. 2011; 12: 347-353
        • Vanmolkot F.H.
        • van Bortel L.M.
        • de Hoon J.N.
        Altered arterial function in migraine of recent onset.
        Neurology. 2007; 68: 1563-1570
        • Wehrwein E.A.
        • Joyner M.J.
        Regulation of blood pressure by the arterial baroreflex and autonomic nervous system.
        in: Buijs R.M. Swaab D.F. Autonomic Nervous System. Elsevier, Edinburgh, London2013: 89-102