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Editor's Correspondence
November 12, 2007

Are We Ignoring the Elephant in the Room?

Arch Intern Med. 2007;167(20):2263-2264. doi:10.1001/archinte.167.20.2263

Cook et al1 reported no association between migraine and coronary heart disease (CHD) after a mean of 12 years of follow-up in the Physicians' Health Study (PHS). This study included information through March 2000. Kurth et al2 extended the follow-up period of the PHS participants to February 2005. They concluded that “migraine was associated with increased risk of major CVD [cardiovascular disease]”2(p795) and that “[t]he associations between migraine and major CVD, ischemic stroke, and MI [myocardial infarction] were not significantly modified by smoking and hypertension status or by randomized aspirin assignment.”2(p797) The authors “had no information about the use of migraine-specific drugs (ie, triptans and ergot alkaloids).”2(p800) However, in a study by the same authors regarding the Women Health Study “women were asked on the 48-month questionnaire to provide information regarding medication use during the previous 2 weeks. The frequency of migraine-specific drug use among women who reported active migraine at baseline was 5.3%.”3(p290) So what did these patients use to treat their migraine?

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