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From the Departments of Epidemiology (K.M.R., A.P.C.) and Biostatistics (D.J.C.), University of North Carolina at Chapel Hill, Department of Ophthalmology and Visual Sciences (R.K.), University of Wisconsin Medical School, Madison, and Department of Epidemiology (A.R.S.), Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; and Centre for Eye Research Australia (T.Y.W.), University of Melbourne, Melbourne, Australia.
Address correspondence and reprint requests to Dr Rose, Department of Epidemiology, University of North Carolina at Chapel Hill, 137 E. Franklin St., Suite 306, Chapel Hill, NC 27514 kathyrn_rose{at}unc.edu
Objective: This study examined the association between vascular headaches and retinal microvascular disease.
Methods: We investigated the cross-sectional association between headaches (migraine/other headaches with aura, migraine without aura, other headaches without aura, no headaches) and retinal microvascular signs (retinopathy, focal arteriolar narrowing, arteriovenous nicking; arteriolar and venular calibers) among middle-aged African American and white men and women from the third examination of the Atherosclerosis Risk in Communities Study (1993 through 1995).
Results: After controlling for age, gender, race, study center, and cardiovascular risk factors, we determined that persons with headaches were more likely to have retinopathy than those without a history of headaches (odds ratio [OR] = 1.38, 95% CI = 0.96 to 1.99 for migraine/other headaches with aura; OR = 1.49, 95% CI = 1.05 to 2.12 for migraine without aura; and OR = 1.28, 95% CI = 0.99 to 1.65 for other headaches). Associations with migraine were stronger among the subset of participants without a history of diabetes or hypertension (OR = 1.79, 95% CI = 1.09 to 2.95 for migraine/other headaches with aura; and OR = 1.74, 95% CI = 1.11 to 2.71 for migraine without aura). Headaches were not associated with focal arteriolar narrowing or arteriovenous nicking. Persons with headaches tended to have smaller mean arteriolar and venular calibers; however, these associations did not tend to persist among those without hypertension or diabetes.
Conclusion: Middle-aged persons with migraine and other headaches were more likely to have retinopathy signs, supporting the hypothesis that neurovascular dysfunction may underlie vascular headaches.
The Atherosclerosis Risk in Communities Study is a collaborative study supported by the National Heart Blood and Lung Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022.
Disclosure: In 2001 Dr. Rose was a paid consultant for and received a small grant from GlaxoSmithKline. These funds did not support the research presented in the current manuscript.
Received October 18, 2006. Accepted in final form January 10, 2007.
This article has been cited by other articles:
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  T. Kurth, M. Schurks, G. Logroscino, J M. Gaziano, and J. E Buring Migraine, vascular risk, and cardiovascular events in women: prospective cohort study BMJ, August 7, 2008; 337(aug07_1): a636 - a636. [Abstract] [Full Text] [PDF]
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 P. Kruszewski, L. Bieniaszewski, and K. M. Rose Migraine and retinal microvascular abnormalities: The Atherosclerosis Risk in Communities Study Neurology, February 12, 2008; 70(7): 579 - 580. [Full Text] [PDF]
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 P. B. Gorelick and J. V. Bowler Advances in Vascular Cognitive Impairment 2007 Stroke, February 1, 2008; 39(2): 279 - 282. [Full Text] [PDF]
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