The intersections of migraine with cardiovascular risk

The gap

Evidence profile

Sourced from the stated research gap and limitations of the source papers, classified as general, spanning 3 journals. Those papers have been cited 1 times in total.

Supporting evidence — 3 representative gaps

• Migraine and Cardiovascular Risk: A Scoping Review of Vascular Outcomes, Risk Assessment, and Endothelial Dysfunction (2026) · Life · doi

  The intersections of migraine with cardiovascular risk stratification, stroke mechanisms, endothelial dysfunction, neuroimaging findings, and neurocognitive profiles remain incompletely mapped, - There is a need for integrated multidisciplinary management of migraine and cardiovascular disease, - Future studies should prioritize sex-stratified longitudinal designs with aura-specific risk modeling and cerebral endothelial assessment

  generalstated research gap
  Keywords: intersections migraine cardiovascular risk stratification stroke mechanisms endothelial
• The association between red blood cell distribution width to albumin ratio and migraine: evidence from clinical and population-based cohorts (2026) · Frontiers in Neurology · doi

  A key strength of the present study is its complementary cohort design: the Chinese clinical cohort identified the association between RAR and ICHD-3-diagnosed migraine in patients presenting with headache, while the NHANES cohort provided complementary epidemiological evidence regarding self-reported severe headache or migraine in the general population. In addition, we performed EPV and VIF assessments to support model stability and used RCS analysis to explore potential nonlinearity. We also collected detailed clinical features of migraine patients in the Chinese cohort, which adds clinical context to the findings. Nonetheless, several critical limitations of this study must be addressed. First, the Chinese clinical cohort was recruited from a single structural heart disease center, which may introduce selection bias and limit the generalizability of our findings to broader migraine populations. In addition, this cohort was retrospective and analyzed using a complete-case approach, so exclusion of patients with missing RAR components or covariate data may also have introduced selection bias. Second, the NHANES outcome was defined by a single self-reported question of “severe headache or migraine in the past three months.” For conservative interpretation, this endpoint should be regarded as self-reported severe headache or migraine rather than clinically confirmed migraine. Outcome misclassification is possible, and we cannot rule out the inclusion of other severe primary headache disorders. Third, the retrospective observational design of the Chinese cohort and the cross-sectional design of the NHANES cohort preclude causal inference and may have led to underreporting of photophobia, phonophobia, and nausea in routine documentation. Moreover, the exploratory analysis involving BMI cannot establish mediation or mechanism because temporal ordering is unavailable. Finally, the relatively limited sample size and substantial baseline imbalances in the Chinese cohort may have contributed to imprecision at the extreme end of the RAR distribution. Although multivariable regression was used to adjust for measured covariates, residual confounding cannot be fully excluded. Accordingly, future investigations should adopt well-defined, large-scale, multicenter, prospective study designs to confirm the observed associations and to improve understanding of the biological processes that may underlie them. Additionally, studies using propensity score matching (PSM) or inverse probability weighting (IPW) to reduce baseline imbalances, and Mendelian randomization to explore potential causal relationships are warranted.

  generallimitationsevidence 5/5
  Keywords: cohort migraine chinese headache clinical severe design tion patients nhanes self reported cannot complementary used
• Exercise as Medicine in Migraine: Clinical Outcomes, Mechanisms, and Long-Term Therapeutic Potential (2026) · Journal of Education Health and Sport · cited 1× · doi

  Despite the promising evidence, several limitations must be acknowledged. The overall certainty of evidence in many meta-analyses remains low, and heterogeneity in study design, intervention protocols, and outcome measures complicates direct comparisons. Additionally, while exercise is generally beneficial, it may also act as a trigger in some individuals, as 16 suggested by epidemiological data identifying physical exertion among common migraine triggers (Aderinto et al., 2024). Future research should focus on high-quality randomized controlled trials with standardized protocols, as well as investigations into personalized exercise prescriptions based on phenotype, chronotype, and comorbidities. Table 3.

  generallimitationsevidence 5/5
  Keywords: evidence protocols exercise despite promising several limitations must acknowledged overall certainty meta analyses remains heterogeneity

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