[Women with migraine have an increased risk of cardiovascular disease; what are the consequences for the clinical management of young patients?]

Migraine is often regarded as a debilitating headache disorder without long-term consequences. However, migraine is an important risk factor for cardiovascular disease, especially in young women who suffer from migraine with aura. This increased risk is not limited to stroke but includes cardiac disease. The absolute risk for cardiovascular disease remains low in young women, however the prevalence of migraine is particularly high in this population. Migraine should therefore be incorporated as a factor in cardiovascular risk assessment. Mechanisms underlying the relationship between migraine and cardiovascular disease are complex and probably multifactorial. Endothelial dysfunction may play a pivotal role. Knowledge about the interaction of migraine with other risk factors and evidence-based recommendations on clinical management remain limited. Lifestyle advice, including the promotion of smoking cessation, is of utmost importance.