![]() Hypertension was defined by multiple criteria: blood pressure >140/90 mm Hg, self-reported hypertension, or use of antihypertensive medication. ![]() 10 Briefly, diabetes mellitus was defined by the patient's self-report of such a history, use of insulin or oral antidiabetic medication, or fasting glucose >126 mg/dL. Our methods for measuring anthropomorphic indices, fasting blood specimens, and blood pressure were obtained as described previously. Smoking was categorized as current (within the past year), former, or never smoker of cigarettes, cigars, or pipes. Standard questions regarding hypertension, diabetes, cigarette smoking, and cardiac conditions were adapted using the Behavioral Risk Factor Surveillance System by the Centers for Disease Control and Prevention. Race/ethnicity was determined through a series of questions modeled after the US census and conforming to standard definitions by Directive 15. Baseline data on demographics, socioeconomic factors, medical history and medication use, vascular risk factors, family history, migraine history, and other health-related information were collected. For our analysis, we excluded participants with a history of meningitis, head trauma, or radiation, to rule out individuals with the potential for secondary headache (n = 378), and those with a myocardial infarction (MI) before baseline (n = 237).ĭata were collected through interviews with trained bilingual research assistants in English or Spanish. The enrollment response rate was 75%, the overall participation rate was 69%, and a total of 3,298 participants were enrolled with an average annual contact rate of 95%. Participants were identified by random-digit dialing (91% telephone response rate) and then recruited for an in-person baseline interview and assessment. ![]() 9 Eligible participants were stroke-free, older than 40 years, and had resided in Northern Manhattan for 3 months or longer, with a telephone. We used the same methodology as that employed in a previous study. The study was approved by the institutional review boards of Columbia University and the University of Miami, and participants provided written informed consent. NOMAS includes 3,289 participants followed prospectively to determine stroke incidence, both novel and traditional risk factors, and prognosis. The NOMAS is a population-based prospective study designed to determine predictors of stroke recurrence and prognosis in a multiethnic, urban population. As a secondary aim, we also explored the association between migraine and vascular events/mortality. The objective of this study was to assess the association between migraine, including both migraine with and without aura, and stroke in the Northern Manhattan Study (NOMAS), an ethnically diverse, older, community-based cohort. Moreover, migraine may be a potentially modifiable vascular risk factor, requiring further exploration in high-risk populations. 3, – 8 However, there are no reliable indicators to predict which migraineurs will develop cerebrovascular ischemic insults and other vascular events. 2 Some studies also suggest that migraine is associated with an unfavorable cardiovascular risk profile, cardiovascular disease events, and vascular death. 1 While the vascular theory of migraine has been disproved, migraine with aura, mostly in women younger than 45 years, has been shown to be an independent risk factor for ischemic stroke. It has been suggested that migraine and stroke exist on a continuum, and the vascular system may have important secondary consequences in migraine. Migraine is a complex neurovascular syndrome resulting in an unstable trigeminal vascular system.
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