According to researchers, pre-existing asthma may be a strong predictor of future chronic migraine attacks in individuals experiencing occasional migraine headaches.
“If you have asthma along with episodic or occasional migraine, then your headaches are more likely to evolve into a more disabling form known as chronic migraine, says Vince Martin, MD, professor of medicine at the University of Cincinnati’s division of General Internal Medicine.
Martin teamed with Richard Lipton, MD, and Dawn Buse PhD, both of Montefiore Headache Center and the Albert Einstein College of Medicine, and Kristina Fanning, PhD, Daniel Serrano, PhD, and Michael Reed, PhD, all from Vedanta Research, to study about 4,500 individuals who experienced episodic migraine or fewer than 15 headaches per month.
“Migraine and asthma are disorders that involve inflammation and activation of smooth muscle either in blood vessels or in the airways,” says Lipton, director of Montefiore Headache Center. “Therefore, asthma-related inflammation may lead to migraine progression.
About 12% of the U.S. population experiences migraine, which is almost 3 times more common in women than in men, according to Martin. Individuals with chronic migraine have headaches 15 or more days per month; this affects about 1% of the U.S. population and takes a severe toll on sufferers who often miss work and social events.
Asthma affects about 8% of American adults, according to the U.S. Centers for Disease and Control Prevention.
Researchers found that after one year of follow-up, new onset chronic migraine developed in 5.4% of participants also suffering from asthma and in 2.5% of people without asthma. “In this study, persons with episodic migraine and asthma at baseline were more than twice as likely to develop chronic migraine after one year, as compared to those with episodic migraine but not asthma,” says Martin.
Researchers have considered various theories as to why asthma may have a predictive role in chronic migraine development for individuals with episodic or occasional migraine. Asthmatic patients are more likely to also have allergies and the researchers have shown in prior studies that patients with allergies might be prone to more frequent migraine particularly if they have hay fever, says Martin.
Another possibility is that patients with asthma may have an overactive parasympathetic nervous system that predisposes them to attacks of both migraine and asthma. It’s also possible that asthma may not directly cause chronic migraine, but that a shared environmental or genetic factor, like air pollution, which has been known to trigger both asthma and migraine attacks may play a role, Martin explains.
Martin says physicians may want to prescribe preventive medications at earlier stages in these patients.
“Also, if allergies are the trigger, it begs the question should we treat allergies more aggressively in these patients?” says Martin.
December 1, 2015