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A history of migraine was linked to an increased risk of hypertension among menopausal women, a large longitudinal cohort study found.

The incident rate of hypertension was 19.2 per 1,000 person-years among menopausal women with migraine, compared with 14.3 per 1,000 person-years in those without migraine (adjusted HR 1.29, 95% CI 1.24-1.35), reported Gianluca Severi, PhD, of Institut National de la Santé et de la Recherche Médicale and Université Paris-Saclay in France, and colleagues.

Women who had been on menopausal hormone therapy had a particularly strong link between migraine and hypertension (P=0.02 for interaction). However, age at menopause and menopause type did not modify the association, they noted in their findings .

Results also persisted after controlling for and presence of auras during migraines.

Notably, the migraine prevention drug erenumab (Aimovig) was recently found to be associated with elevated blood pressure (BP) based on postmarketing case reports.

"There are multiple ways in which migraine may be linked to high BP," Severi said in a press release. "People with migraine have been shown to have early signs of arterial stiffness. Stiffer, smaller vessels are not as capable of accommodating blood flow, resulting in pressure increases. It is also possible that associations could be due to genetics."

"Since previous research shows migraine increases the likelihood of , identification of additional risk factors such as the higher likelihood of high BP among people with migraine could aid in individualized treatment or prevention. Doctors may want to consider women with a history of migraine at a higher risk of high BP," he suggested.

The study included 56,202 menopausal women who did not have hypertension or cardiovascular disease at age of menopause onset. Participants were part of the , which includes adult women insured by a health plan for workers in the National Education System in France.

Enrollment began in 1990 and participants were asked to complete questionnaires on lifestyle and disease every 2-3 years. Self-reported migraine data were collected beginning in 1993, with aura status collected starting in 2011. Follow-up was available through 2014.

In 1993, 9,543 women reported ever having had a migraine, a number that grew to 11,030 in 2005. Migraine sufferers were more likely to report familial cardiovascular disease and dyslipidemia, not smoking, and previous use of menopausal hormone therapy.

Study authors posited that an additive interaction effect from menopausal hormone therapy and migraine may exist, or it may be that women with migraine have more frequent visits to clinicians, potentially increasing rates of hypertension diagnosis.

In general, residual and unmeasured confounding could not be excluded by the study's observational design.

Furthermore, the investigators' reliance on self-reported migraine and hypertension data was a major limitation of the study. Since the cohort was limited to education workers, the results may not be generalizable to the general population, Severi and colleagues cautioned.

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