Migraines, often dismissed as severe headaches, are increasingly recognized as a potential indicator of underlying cardiovascular risk, according to research published in recent years. The connection, particularly pronounced in individuals experiencing migraines with aura, is prompting medical professionals to consider a more holistic approach to patient care.
A study published in JAMA in 2020, tracking nearly 28,000 women aged 45 and older, revealed a slightly elevated annual rate of heart attack, stroke, or cardiovascular death among those reporting migraines with aura – 3.4 per 1,000 women – compared to those without migraines or with migraines without aura (2.1 per 1,000 women). Even as the absolute risk remains relatively low, the findings underscore a statistically significant association.
“Migraines tend to be most common in younger women, and their baseline risk of stroke is quite low in the first place,” explained Dr. Christopher Anderson of Brigham and Women’s Hospital, in a report by Harvard Health. This context is crucial, he noted, when interpreting the increased risk observed in migraine sufferers.
The link between migraines and cardiovascular disease isn’t simply correlational. Researchers believe shared underlying mechanisms contribute to both conditions. A December 2025 report from Oklahoma Heart Institute highlighted that migraines involve changes in blood vessels, nerves, and brain chemistry, processes that directly impact the cardiovascular system. During a migraine, blood vessels in the brain initially narrow and then widen, affecting blood flow throughout the body. Inflammation and hormonal shifts are also implicated.
The association appears strongest with migraines with aura – those characterized by temporary visual or sensory disturbances preceding the headache. A study published in the BMJ found that migraines were linked to a greater likelihood of major cardiovascular events, even after accounting for traditional risk factors. Researchers suggest that inflammation in blood vessels and vascular reactivity may play a key role.
Several shared risk factors further complicate the relationship. High blood pressure, high cholesterol, smoking, a sedentary lifestyle, and a family history of heart disease or stroke are all known to both trigger migraines and increase cardiovascular risk. Managing these factors, experts say, can benefit both conditions.
The American College of Cardiology highlighted in August 2023 that migraine is associated with increased risk for stroke, obstructive coronary artery disease, including myocardial infarction, and atrial fibrillation. The organization’s report emphasized the need for clinicians to be aware of this connection when evaluating patients with migraines.
Despite growing evidence, the precise nature of the relationship remains under investigation. Researchers are working to determine whether migraines are simply a marker for underlying cardiovascular vulnerability, or if they actively contribute to the development of heart disease. Further research is planned to explore the potential benefits of targeted interventions for migraine sufferers at increased cardiovascular risk.
