Young adults with migraines have a greater stroke risk 

Younger adults, specifically those 35 to 45 years old, might face a heightened risk of suffering a stroke – not from the widely recognized traditional risk factors such as hypertension – but rather from nontraditional risk factors, including migraines. This is the conclusion of a new study published in the journal Circulation: Cardiovascular Quality and Outcomes.

The research shifts the narrative towards the substantial role that these less conventional factors play in stroke risk among younger adults, challenging the established understanding of stroke etiology.

Traditional stroke risk factors

Historically, the medical community has pinpointed a series of traditional risk factors responsible for the majority of stroke cases. These include, but are not limited to, high blood pressure, high cholesterol levels, Type 2 diabetes, smoking habits, obesity, sedentary lifestyle, excessive alcohol consumption, and coronary heart disease. 

However, a disturbing trend has been observed with a rising number of stroke incidents reported among young adults who do not exhibit these conventional risk factors, pointing towards the significant influence of environmental and lifestyle factors in stroke occurrence.

Contributors to stroke among young adults

“We wanted to understand which risk factors were the top contributors to stroke risk among young adults,” said lead author Michelle Leppert, an assistant professor of neurology at the University of Colorado School of Medicine in Aurora, Colorado. To achieve this, the researchers utilized a robust administrative database encompassing health insurance claims within Colorado. 

The team meticulously compared the data of over 2,600 individuals who had experienced strokes against a control group of more than 7,800 individuals without stroke history to pinpoint the predominant risk factors leading to strokes.

Nontraditional stroke risk factors

The investigation revealed a significant association between nontraditional stroke risk factors – including migraines, blood clotting disorders, kidney failure, autoimmune diseases, and malignancy – and the development of strokes in individuals aged 18 to 44 years. 

Notably, this association was even stronger among adults younger than 35 years, highlighting the disproportionate impact of these nontraditional risk factors on the younger population.

Specifically, the analysis indicated that within the 18 to 34-year-old demographic, strokes linked to nontraditional risk factors constituted 31% in men and approximately 43% in women, surpassing those attributed to traditional risk factors. 

Migraines emerged as a critical nontraditional risk factor

Remarkably, migraines emerged as a critical nontraditional risk factor, responsible for 20% of strokes in men and nearly 35% in women within this age group. While the relevance of traditional stroke risk factors seemed to peak among adults aged 35 to 44, the influence of nontraditional risk factors remained substantial across different age groups.

“These findings are significant because most of our attention has been focused on traditional risk factors. We should not ignore nontraditional stroke risk factors and only focus on traditional risk factors; both are important to the development of strokes among young people,” Leppert said. 

“In fact, the younger they are at the time of stroke, the more likely their stroke is due to a nontraditional risk factor. We need to better understand the underlying mechanisms of these nontraditional risk factors to develop targeted interventions.”

Association between migraines and stroke risk

Furthermore, the study brought to light the unexpected prominence of migraines in the etiology of strokes among young adults – a connection previously noted in the medical literature but not quantified to this extent. 

“There have been many studies demonstrating the association between migraines and strokes, but to our knowledge, this study may be the first to demonstrate just how much stroke risk may be attributable to migraines,” Leppert explained.

Possible study limitations 

Derived from data spanning 2012 to 2019 from the Colorado All Payer Claims Database, the study’s robust dataset allowed for an in-depth analysis, although it acknowledged certain limitations such as the reliance on administrative databases which might influence the accuracy in risk factor identification, and a lack of comprehensive data on race and ethnicity for a sizable portion of participants. 

In addition, the research was focused on metropolitan areas one mile or more above sea level, so altitude may create unique conditions which are not applicable to individuals living at other altitudes.

Further stroke risk assessment studies are needed

By casting a spotlight on the crucial role of nontraditional risk factors in stroke development among younger populations, this research enriches our current understanding of stroke risk factors, while calling for further risk assessment studies. 

These future endeavors should aim to clarify the full spectrum of influences contributing to stroke risk, ultimately paving the way for more effective prevention strategies tailored to the needs of younger adults.

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