Half Headache, Half Heartache

By JOHN O'NEIL

Published: December 28, 2004

People who have migraines experience more chest pain similar to angina than people who don't, but the people with migraines are no more likely to have heart attacks, a study has found.

An editorial accompanying the study, in the current journal Neurology, called the results reassuring. Angina is generally caused by blocked coronary arteries, and some migraine medicines are known to constrict blood flow in the arteries.

The study's lead researcher, Dr. Kathryn M. Rose of the University of North Carolina, said the findings did not mean that people with migraines should ignore chest pain, which she called "an important symptom of a number of conditions, including coronary artery disease."

The study was based on data on 12,409 people, about 20 percent of them reporting histories of headaches of four hours or longer. At the beginning of the study and in later visits, they were asked about the symptoms indicating angina. Data about heart attacks and other complications of heart disease were gathered from hospital and other records over the next 12 years.

The researchers found that chest pain was most common among people with headaches that included the visual hallucinations called auras. They were two to three times as likely to report episodes of chest pain during exertion as people who did not have the headaches. But no difference existed in rates of heart attacks or heart disease between people with and without migraines.

Dr. Rose said the findings suggested that the higher prevalence of chest pain among the migraine group might be related to something other than coronary disease. "People with migraine may have greater sensitivity to pain," she said, or be prone to artery spasms.