A prospective study of migraine history and venous thromboembolism in older adults

ESSENTIALS: A few studies suggested that migraine increases venous thromboembolism (VTE) risk. We conducted a prospective US population‐based study. Migraine history did not appear to increase risk of VTE. Older patients with migraine should require only standard VTE prophylaxis. BACKGROUND: Limited evidence suggests that migraine might be a risk factor for venous thromboembolism (VTE). We conducted an epidemiologic study to assess whether migraine history is associated prospectively with VTE or cross sectionally with hemostatic risk markers for VTE. METHODS: In a population‐based US cohort, 11 985 participants free of VTE reported headache symptoms in 1993‐1995. We classified participants as having either migraines with or without aura, severe nonmigraine headaches, or no severe headaches. We followed them through 2015 for incident VTE verified by medical records. RESULTS: Participants’ mean age at baseline was 60 years (SD: 6). Eleven percent were classified as having a migraine history (932 without aura and 396 with aura). Over a mean of 18 years and 211 913 person‐years at risk, 688 participants developed VTE. Participants with a migraine history had no greater risk of VTE compared with those free of severe headache (adjusted hazard ratio [HR]: 1.06, 95% confidence interval [CI]: 0.82‐1.36). Those with migraine history with aura had an HR of 1.25 (95% CI: 0.85‐1.85). Self‐reported physician diagnosis of migraine carried an HR of 1.22 (0.96‐1.55). At baseline, those with a history of migraine, furthermore, did not have a higher frequency of elevated hemostatic risk factors or a higher genetic risk score for VTE. CONCLUSION: This study does not support the hypothesis that migraine history is an important risk factor for VTE in older adults.