Existing research shows certain types of migraines can increase the risk of stroke, and there is growing evidence that they may also lead to other types of cardiovascular disease (CVD). To learn more about these connections, the American Heart Association, the world's leading nonprofit organization focused on heart and brain health for all, is providing a total of $2.1 million in grants for seven new scientific research projects. The selected teams of scientists for the "Migraine as a Risk Factor for Stroke and Cardiovascular Disease" projects are from: Brigham and Women's Hospital in Boston, Massachusetts; Mayo Clinic in Rochester, Minnesota.; Mayo Clinic in Phoenix, Arizona.; Duke University School of Medicine in Durham, North Carolina; Rhode Island Hospital in Providence; the University of South Carolina in Columbia; and Yeshiva University in New York City.

According to the American Migraine Foundation, 39 million people in the U.S. experience migraines. And while evidence suggests that migraines increase the risk of strokes and possibly other types of cardiovascular disease, there is still much we don't know about what causes this increased risk. With these new research grants, we hope to create a collaborative group of experts in migraine, cardiovascular disease, stroke, biostatistics and data science to explore these unanswered questions about the cardiovascular complications of migraine."

Mitchell S. V. Elkind, M.D., M.S., FAHA, neurologist, chief clinical science officer of the American Heart Association

Specifically, the researchers are charged with bringing new ideas to analyze and standardize migraine research data from already accumulated datasets in the American Heart Association's Precision Medicine Platform. This platform is a state-of-the art, cloud-based system that allows researchers to collaborate and analyze large datasets from any computer in the world using a secure environment and the power of machine learning. They'll pull from existing research on different study populations, including epidemiological studies, clinical trial data, electronic health record data, imaging data, genetic data and more.

The seven research projects, which began July 1, 2023, and are funded for up to two years each, include:

• Genetics-informed discovery of etiologic predictors of cardiovascular events among individuals with migraine at Brigham and Women's Hospital (BWH) – led by Daniel Chasman, Ph.D., an associate professor of medicine at Harvard Medical School and an associate geneticist at BWH, and Pamela Rist, Sc.D., an assistant professor of medicine at Harvard Medical School and an associate epidemiologist at BWH, this team will work to identify new ways of assessing CVD risk among people with migraine. They will determine if there are known risk factors common to both migraine and CVD; search for genes that may contribute to the risk of stroke among people with migraine to determine if these genes may uncover novel biomarkers for CVD risk; and finally, use genetic scores to attempt to discover new risk factors for CVD among those with migraine.

• Artificial Intelligence ECG-Based Screening and Prediction Tool to Identify Migraine Patients at Risk for Stroke and CVD at Mayo Clinic in Rochester – led by Chia-Chun Chiang, M.D., a headache specialist and vascular neurologist at Mayo, this team will develop a screening tool to help doctors better identify patients with migraine who may have a higher chance of having a stroke or heart problem, like a heart attack. The tool will be based on an electrocardiogram (ECG), which shows the electronic signals of the heart, and will use artificial intelligence (AI) to analyze the ECG readings, while taking into consideration other patient factors like age, other illnesses and specific features of their headaches. The goal of the tool is to help doctors determine if more tests are needed or if patients need to do certain things to lower their risk and hopefully prevent stroke and heart problems.

• Risk modeling of stroke and cardiovascular disease in patients with migraine at Mayo Clinic in Phoenix – led by Catherine Chong, Ph.D., an associate professor of neurology at Mayo, this team will develop a model that includes migraine factors to predict the risk of stroke and heart disease in people with migraine. This model will be built using information from two large databases. A precise prediction model such as this is important for early identification of those at high risk of stroke and heart disease.

• MARS: The Migraine And Retinal Stroke Study at Duke University School of Medicine – led by Brian Mac Grory, M.B., B.Ch., M.R.C.P., a vascular neurologist at Duke Health, this team will study the connection between migraine and a less common type of stroke, an ocular stroke, which is a stroke in the back of the eye known as the retina. Using a large data warehouse containing data on people from across the U.S., they will look at what puts people at risk of eye strokes compared with brain strokes and whether migraine medications play a role in causing eye strokes. This can help in early identification and treatment of this type of stroke.

• Migraine and Stroke in Women: Leveraging the Observational and Clinical Trial Cohorts of the Women's Health Initiative at Rhode Island Hospital (RIH) – led by Tracy Madsen, M.D., Sc.M., Ph.D., the associate director of the Sex and Gender in Emergency Medicine Program at RIH, this team will study data from over 160,000 women to better explain the link between migraine and stroke risk in women after menopause. They will study other factors that may raise stroke risk for women with migraine, like high blood pressure, diabetes and the use of medicines such as hormones. Finally, they will look at how problems like inflammation and blood clotting change stroke risk in women with menopause. This research will help women with migraine and their doctors find ways to reduce their risk of stroke.

• Testing the role of heart rate variability (HRV) in predicting atrial fibrillation and ischemic stroke in migraine at the University of South Carolina (USC) – led by Souvik Sen, M.D., M.S., M.P.H., the neurology department chair and a clinical professor at USC School of Medicine, this team will explore the risk of stroke and atrial fibrillation (a type of irregular heartbeat) in young people with migraine. They will use data from the large Atherosclerosis Risk in Communities (ARIC) Study, a large research study from the National Heart, Lung, and Blood Institute of National Institutes of Health.

• Migraine as a Risk Factor for Cardiovascular Events in the Veterans Health Administration at Yeshiva University (YU) – led by Elizabeth Seng, Ph.D., an associate professor of psychology at YU, this team will study data on veterans who had migraine, and those who had no headache, during 2008-2012. They will look at 10 years of data to identify how many veterans in each group had a heart disease event or a stroke and at the specific characteristics of those people who had migraine and were more likely to have a CVD event. They will also test the use of adding migraine to diagnostic tools to help better identify people who are at risk for a heart disease event or stroke.

The American Heart Association has funded more than $5 billion in cardiovascular, cerebrovascular and brain health research since 1949, making it the single largest non-government supporter of heart and brain health research in the U.S. New knowledge resulting from this funding benefits millions of lives in every corner of the U.S. and around the world.