TY - JOUR
T1 - Hormonal contraceptives and risk of ischemic stroke in women with migraine
T2 - a consensus statement from the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESC)
AU - Sacco, Simona
AU - Merki-Feld, Gabriele S
AU - Ægidius, Karen Lehrmann
AU - Bitzer, Johannes
AU - Canonico, Marianne
AU - Kurth, Tobias
AU - Lampl, Christian
AU - Lidegaard, Øjvind
AU - Anne MacGregor, E
AU - MaassenVanDenBrink, Antoinette
AU - Mitsikostas, Dimos-Dimitrios
AU - Nappi, Rossella Elena
AU - Ntaios, George
AU - Sandset, Per Morten
AU - Martelletti, Paolo
AU - European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESC)
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Several data indicate that migraine, especially migraine with aura, is associated with an increased risk of ischemic stroke and other vascular events. Of concern is whether the risk of ischemic stroke in migraineurs is magnified by the use of hormonal contraceptives. As migraine prevalence is high in women of reproductive age, it is common to face the issue of migraine and hormonal contraceptive use in clinical practice. In this document, we systematically reviewed data about the association between migraine, ischemic stroke and hormonal contraceptive use. Thereafter a consensus procedure among international experts was done to develop statements to support clinical decision making, in terms of cardiovascular safety, for prescription of hormonal contraceptives to women with migraine. Overall, quality of current evidence regarding the risk of ischemic stroke in migraineurs associated with the use of hormonal contraceptives is low. Available data suggest that combined hormonal contraceptive may further increase the risk of ischemic stroke in those who have migraine, specifically migraine with aura. Thus, our current statements privilege safety and provide several suggestions to try to avoid possible risks. As the quality of available data is poor further research is needed on this topic to increase safe use of hormonal contraceptives in women with migraine.
AB - Several data indicate that migraine, especially migraine with aura, is associated with an increased risk of ischemic stroke and other vascular events. Of concern is whether the risk of ischemic stroke in migraineurs is magnified by the use of hormonal contraceptives. As migraine prevalence is high in women of reproductive age, it is common to face the issue of migraine and hormonal contraceptive use in clinical practice. In this document, we systematically reviewed data about the association between migraine, ischemic stroke and hormonal contraceptive use. Thereafter a consensus procedure among international experts was done to develop statements to support clinical decision making, in terms of cardiovascular safety, for prescription of hormonal contraceptives to women with migraine. Overall, quality of current evidence regarding the risk of ischemic stroke in migraineurs associated with the use of hormonal contraceptives is low. Available data suggest that combined hormonal contraceptive may further increase the risk of ischemic stroke in those who have migraine, specifically migraine with aura. Thus, our current statements privilege safety and provide several suggestions to try to avoid possible risks. As the quality of available data is poor further research is needed on this topic to increase safe use of hormonal contraceptives in women with migraine.
U2 - 10.1186/s10194-017-0815-1
DO - 10.1186/s10194-017-0815-1
M3 - Journal article
C2 - 29086160
SN - 1129-2369
VL - 18
JO - Journal of Headache and Pain
JF - Journal of Headache and Pain
M1 - 108
ER -