该研究评估了偏头痛与心血管疾病(CVD)死亡在美国人群中的关联。先前的研究根据不同人群得出了关于偏头痛和CVD死亡的关联的不同结论，因此，探讨偏头痛与CVD死亡在美国人群中的关系是很重要的。这项前瞻性队列研究纳入了1999-2004年国家健康与营养调查(NHANES)的10,644名参与者。自2019年12月31日起，通过将队列数据库与国家死亡指数进行链接以获取死亡数据。根据第十次修订疾病国际分类，CVD死亡包括以下疾病代码：I00-I09(急性风湿热和慢性风湿性心脏病)，I11(高血压性心脏病)，I13(高血压性心脏病和肾脏病)，I20-I25(缺血性心脏病)，I26-I28(肺栓塞和其他急性肺心病)，I29(各种因不同原因引起的心血管疾病)，I30-I51(其他形式的心脏病)和I60-I69(脑血管疾病)。数据分析时间为2022年10月至11月。在纳入研究的10,644名成年人中(平均年龄46.4 [0.3]岁，男性5430人[47.4%])，有2106人(20.4%)患有偏头痛。在中位随访期为201个月的过程中，共有3078例全因死亡和997例CVD死亡。与无偏头痛者相比，偏头痛患者调整后的风险比(HR)为1.30 (95% [CI],1.04-1.62；p=0.019)，用于CVD死亡的风险比为1.23(95% CI,1.13-1.35；p<0.001)。在亚组分析中，偏头痛与CVD死亡在女性参与者中有关(HR=1.43，95% CI=1.06-1.93)，在年龄<45岁者中有关(HR=1.69，95% CI=1.04-2.76)，在非西班牙裔白人(HR=1.42，95% CI=1.09-1.86)，体质指数<30 kg/m2 (HR=1.36，95% CI=1.03-1.78)，前吸烟者或现吸烟者(HR=1.36，95% CI=1.00-1.85)，前饮酒者或现饮酒者(HR=1.33，95% CI=1.03-1.72)，以及无代谢综合征者(HR=1.31，95% CI=1.01-1.71)中有关。在敏感性分析中，偏头痛与CVD死亡之间的关联在排除随访期内死亡的参与者(HR=1.31，95% CI=1.05-1.65)或基线时有癌症史的参与者(HR=1.28，95% CI=1.01-1.62)后仍然稳固。在美国人群中，偏头痛与较高的CVD死亡率相关。© 2023美国头痛学会。

The study assessed the association between migraine and cardiovascular disease (CVD) mortality in the US population.Previous studies have drawn different conclusions about the association between migraine and CVD mortality based on different populations; therefore, it is important to explore the relationship between migraine and CVD mortality in the US population.This prospective cohort study included 10,644 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. Participants who reported having severe headache or migraine were classified as having migraine. Mortality data were obtained by linkage of the cohort database to the National Death Index as of December 31, 2019. Based on the International Classification of Diseases, Tenth Revision, CVD mortality includes the following disease codes: I00-I09 (acute rheumatic fever and chronic rheumatic heart diseases), I11 (hypertensive heart disease), I13 (hypertensive heart and renal disease), I20-I25 (ischemic heart diseases), I26-I28 (pulmonary embolism and other acute pulmonary heart diseases), I29 (various cardiovascular diseases caused by different reasons), I30-I51 (other forms of heart disease), and I60-I69 (cerebrovascular diseases). Data were analyzed from October to November 2022.Among 10,644 adults included in the study (mean age, 46.4 [0.3] years, 5430 men [47.4%]), 2106 (20.4%) had migraine. During a median follow-up period of 201 months, there were 3078 all-cause deaths and 997 CVD deaths. Compared to individuals without migraine, those with migraine had an adjusted hazard ratio (HR) of 1.30 (95% confidence interval [CI], 1.04-1.62; p = 0.019) for CVD mortality and 1.23 (95% CI, 1.13-1.35; p < 0.001) for all-cause mortality. In subgroup analyses, migraine was associated with CVD mortality in participants who were women (HR, 1.43; 95% CI, 1.06-1.93), aged < 45 years (HR, 1.69; 95% CI, 1.04-2.76), non-Hispanic White (HR, 1.42; 95% CI, 1.09-1.86), those with a body mass index < 30 kg/m2 (HR, 1.36; 95% CI, 1.03-1.78), former or current smokers (HR, 1.36; 95% CI, 1.00-1.85), former or current alcohol drinkers (HR, 1.33; 95% CI, 1.03-1.72), and those without metabolic syndrome (HR, 1.31; 95% CI, 1.01-1.71). The association between migraine and CVD mortality was robust in sensitivity analyses, after excluding participants who died within 2 years of follow-up (HR, 1.31; 95% CI, 1.05-1.65) or those with a history of cancer at baseline (HR, 1.28; 95% CI, 1.01-1.62).Migraine was associated with a higher CVD mortality rate in the US population.© 2023 American Headache Society.