{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:10:43Z","timestamp":1780373443546,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,10,9]],"date-time":"2017-10-09T00:00:00Z","timestamp":1507507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000019","name":"National Hemophilia Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000019","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100003983","name":"National Headache Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100003983","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Headache"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular (CV) events, conditions, and procedures (ECPs) are common in persons with migraine and are a contraindication to triptan and ergot use. In a prior study, we estimated that there are 2.6 million American adults with episodic migraine (EM) who have had CV ECPs. However, the prior analysis did not assess persons with migraine without CV ECPs who are at high risk for a first cardiovascular disease (CVD) event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To use the Framingham nonlaboratory CVD events risk equation to estimate the number of individuals with EM who are at elevated risk for a first CVD event in the next 10 years using data from the American Migraine Prevalence and Prevention Study, and then to extrapolate the findings to the US population to estimate the scope of people with EM for whom triptan and ergot therapies may be problematic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from respondents to the 2009 American Migraine Prevalence and Prevention (AMPP) Study questionnaire aged \u226522 who met criteria and headache day frequency for EM were included in this cross\u2010sectional analysis. Ten\u2010year, first CVD event risk was calculated using the nonlaboratory Framingham CV disease risk score (FRS). Variables were collected via respondent self\u2010report and included sex, age, height, and weight to calculate body mass index (BMI), smoking status, and the presence of hypertension and diabetes among other variables. Standard FRS cut scores of \u226521 for women and \u226516 for men were used, which indicate a 30% or greater risk of a first CVD event in the next 10 years. History of CV ECPs was collected via self\u2010report of ever having the ECP and for events and conditions that were diagnosed by a physician. We applied rates of positive ECPs and rates of high FRS to age and sex stratified estimates of the number of people with EM in the US derived from 2015 US Census data to estimate rates of both in the population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The AMPP Study analysis sample included 5227 women and 1496 men with EM. Results showed that 69.5% of women and 73.4% of men had at least one CV risk factor from the FRS, 38.9% of women and 41.6% of men had \u22652 risk factors, and 18.6% of women and 19.1% of men had \u22653 risk factors. The proportion of women with high FRS was 0% for those aged 22\u201039, 0.8% (95%CI: 0.5\u20101.2%) among 40\u2010 to 59\u2010year\u2010olds and 15.2% (95% CI: 13.3\u201017.4%) among the \u226560 age group. For men, the corresponding proportions were 0, 7.3% (95% CI: 5.7\u20109.4%), and 53.0% (95% CI: 4.7\u201058.1%). Projecting to a national US sample, the number of persons with EM and high FRS was 403,000 for women and 510,000 for men. The proportion of women and men at high risk for future CV events based on a prior CV ECP, a high FRS or both increased with age from 20\u201039 (women 4.5%, men 4.2%), 40\u201059 (women 11.8%, men 18.6%), and \u226560 (women 31.2%, men 61.8%). An estimated 141,000 men aged 40\u201059 and 187,000 aged \u226560 and 34,000 women aged 40\u201059 and 181,000 women aged \u226560 in the US population with EM have not had a CV ECP but are at increased risk for a future CV event within the next 10 years based upon their FRS alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among people with EM in the US population, the number of women and men with relative contraindications to triptans and ergots based on a high FRS includes over 900,000 women and men. This includes more than half a million individuals with EM who have not had a prior CV ECP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.13179","type":"journal-article","created":{"date-parts":[[2017,10,9]],"date-time":"2017-10-09T03:06:38Z","timestamp":1507518398000},"page":"1507-1521","source":"Crossref","is-referenced-by-count":61,"title":["Framingham\u2010Based Cardiovascular Risk Estimates Among People With Episodic Migraine in the US Population: Results from the American Migraine Prevalence and Prevention (AMPP) Study"],"prefix":"10.1111","volume":"57","author":[{"given":"Richard B.","family":"Lipton","sequence":"first","affiliation":[{"name":"Department of Neurology Albert Einstein College of Medicine and Montefiore Headache Center Bronx NY (Richard B. Lipton and Dawn C. Buse)"},{"name":"Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx NY (Richard B. 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