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Association Between Migraine and Cardiovascular Disease in Women—Reply
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In Reply: Drs Young and Shaw argue that potential misclassification and residual confounding limit the interpretation of our study on migraine and risk of CVD in women. In this prospective cohort study of more than 27 000 middle-aged women, we found that women who self-reported active migraine with aura but not active migraine without aura had increased risk of overall and specifically ischemic CVD during a mean of 10 years of follow-up. Although misclassification is of concern in any observational study, the issue is whether potential misclassification is differentially influenced by the outcome of interest or not. In our study, migraine and aura information was ascertained at baseline, after which follow-up of incident CVD began. Since it is very unlikely that a future CVD event influenced a woman's response to the migraine or aura question at study entry, any potential misclassification would likely be random (or nondifferential) and would lead to . . . [Full Text of this Article]
Tobias Kurth, MD, ScD
tkurth@rics.bwh.harvard.edu
J. Michael Gaziano, MD, MPH;
Nancy Cook, ScD
Department of Medicine
Brigham and Women's Hospital
Harvard Medical School
Boston, Mass
Giancarlo Logroscino, MD, PhD
Department of Epidemiology
Harvard School of Public Health
Boston, Mass
Hans-Christoph Diener, MD, PhD
Department of Neurology
University of Duisburg-Essen
Essen, Germany
Julie E. Buring, ScD
Department of Medicine
Brigham and Women's Hospital
Harvard Medical School
Boston, Mass
RELATED LETTER
Association Between Migraine and Cardiovascular Disease in Women
William B. Young and James W. Shaw
JAMA. 2006;296(22):2677.
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