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From the Department of Epidemiology (Dr. Rose, A.P. Carson), School of Public Health, University of North Carolina at Chapel Hill, and North Carolina Department of Health and Human Services (C.P. Sanford), Raleigh; Galt Associates, Inc. (Dr. Stang), Blue Bell, PA; University of Mississippi Medical Center (Dr. Brown), Jackson; Division of Epidemiology (Dr. Folsom), School of Public Health, University of Minnesota, Minneapolis; and Department of Epidemiology (Dr. Szklo), Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
Address correspondence and reprint requests to Dr. K. Rose, Cardiovascular Disease Program, Department of Epidemiology, University of North Carolina at Chapel Hill, 137 E. Franklin St., Suite 306, Chapel Hill, NC 27514; e-mail: kathryn_rose{at}unc.edu
Objective: To examine the association between a lifetime history of migraines and other headaches with and without aura and Rose angina and coronary heart disease (CHD).
Methods: Participants were 12,409 African American and white men and women from the Atherosclerosis Risk in Communities Study, categorized by their lifetime history of headaches lasting 
4 hours (migraine with aura, migraine without aura, other headaches with aura, other headaches without aura, no headaches). Gender-specific associations of headaches with Rose angina and CHD, adjusted for sociodemographic and cardiovascular disease risk factors, were evaluated using Poisson regression.
Results: Participants with a history of migraines and other headaches were more likely to have a history of Rose angina than those without headaches. The associations were stronger for migraine and other headaches with aura (prevalence ratio [PR] = 3.0, 95% CI = 2.4, 3.7 and PR = 2.0, 95% CI = 1.5, 2.7 for women; PR = 2.2, 95% CI = 1.2, 3.9 and PR = 2.4, 95% CI = 1.4, 3.9 for men) than for migraine and other headaches without aura (PR = 1.5, 95% CI = 1.2, 1.9 and PR = 1.3, 95% CI = 1.1, 1.6 for women; PR = 1.9, 95% CI = 1.2, 2.9 and OR = 1.4, 95% CI = 1.0, 1.8 for men). In contrast, migraine and other headaches were not associated with CHD, regardless of the presence of aura.
Conclusions: The lack of association of migraines with coronary heart disease suggests that the association of migraine with Rose angina is not related to coronary artery disease. Future research assessing other common underlying pathologic mechanisms is warranted.
Received February 13, 2004. Accepted in final form July 14, 2004.
See also page 2209
Dr. Rose was a paid consultant for GlaxoSmithKline. Dr. Stang is a paid consultant for GlaxoSmithKline, Bristol Myers Squibb, Pfizer, MedImmune, AstraZeneca, Allegran, Procter and Gamble, and ScheringPlough. Dr. Brown was a paid consultant for Bristol Myers Squibb and currently serves on the speaker’s bureau for Merck.
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