Mitigating arterial compliance to diminish migraine risk: A hypothesis

Abstract

Migraine is a disabling neurovascular disorder that primarily affects young people and women, despite their generally high arterial compliance. We hypothesize that a reduction in arterial compliance may lower the risk of migraine. This counter – intuitive view is supported by the observation that young people and women, who typically have better vascular compliance, have the highest prevalence of migraine, while diseases associated with reduced compliance, such as diabetes, show a lower incidence of migraine. Using Mendelian randomization with genetic variants related to pulse pressure as a proxy for arterial compliance, our study found that a higher pulse pressure (indicating lower compliance) was associated with a reduced risk of migraine. This is consistent with the mechanisms of current migraine treatments, such as triptans, CGRP inhibitors, and warfarin, which reduce arterial compliance, and vasodilators like nitroglycerin, which can trigger migraines by increasing compliance. If confirmed, this hypothesis could transform our understanding of the pathophysiology of migraine and inspire new treatment strategies targeting arterial compliance. Future research should further explore this relationship through clinical and experimental studies to elucidate the potential mechanisms and applications for migraine prevention and treatment.