Women With Certain Types Of Migraines Have Higher Risk Of Heart Disease; Many Study Authors Did Not Report Ties To Pharmaceutical Companies

Women who have migraines with visual problems have increased risk for heart disease, according to a study published on Wednesday in the Journal of the American Medical Association, Long Island Newsday reports. For the study, researchers at the Harvard School of Public Health and Brigham and Women's Hospital analyzed the records of 27,800 women older than age 45 who participated in the Women's Health Initiative. None of the women had heart disease when they entered the study between 1992 and 1995. Researchers focused on the records of 5,125 women who had a history of migraines. According to the study, participants who had migraines with migraine aura had more than twice the normal risk for major cardiovascular events. Migraine aura "is a visual sensation -- like lights flashing or lines zigzagging, with some reports of temporary blindness" -- that often lasts for 20 minutes to one hour before migraines begin, Newsday reports. Women who had migraines without migraine aura did not have an increased risk for major cardiovascular events, the study finds. Lead study author Tobias Kurth said that researchers did not determine the cause of the link between migraine aura and heart disease and that the increased risk was small, with about 18 additional cases of heart disease per 10,000 women with migraine aura. Mark Gudesblatt, a neurologist at South Shore Neurologic Associates, said, "It's an important study because it tells you not to take these things lightly" (Talan, Long Island Newsday, 7/19).

Study Authors Did Not Report Financial Ties
The six authors of the study did not disclose to JAMA that they have consulted for, or received research funds from, pharmaceutical companies that manufacture treatments for heart disease or migraines, the AP/Miami Herald reports. JAMA in January implemented a policy that requires financial disclosures from researchers before acceptance of studies for publication, and an editorial published in the journal last week indicated that "JAMA was getting tougher as a result of ... recent breaches" of the policy, the AP/Herald reports. JAMA Editor in Chief Catherine DeAngelis said that journal editors were not aware of the financial ties until the Associated Press informed her about them last week. The authors said they did not report the financial ties because the study does not promote a treatment. JAMA on Tuesday published online a letter from the authors of the study to explain their failure to disclose the financial ties, as well as a response from DeAngelis and a correction. DeAngelis said that the letter, her response and the correction will appear in a future print edition of JAMA. "Let me decide what's pertinent or not," DeAngelis said, adding, "Authors should always err on the side of full disclosure." Kurth in an interview said that the financial ties "do not represent a conflict of interest" (Tanner, AP/Miami Herald, 7/19).

WSJ Examines Issue
In related news, the Wall Street Journal on Wednesday examined how a "spate of recent lapses" from several medical journals has prompted "calls for more journals to ban offending authors from publication." In addition, "medical schools are being urged to regulate relationships between their researchers and industry more closely," the Journal reports. Sheldon Krimsky, a professor at Tufts University who has studied the issue, said, "If journals are going to have ethical standards and if those ethical standards are going to mean anything, there has to be sanctions associated with them." However, many journal editors "are reluctant to ban authors, partly out of concern these researchers will shop their work to a different publication," the Journal reports. DeAngelis has asked medical schools to investigate potential conflicts of interests among their researchers and issue sanctions when appropriate. She said that sanctions have resulted each time she has asked medical schools to investigate their researchers. Jerome Kassirer, a former New England Journal of Medicine editor, said that medical schools require "more stringent policies" because "faculty members are just up to their ears in financial conflicts and academic medical centers are just not doing anything about it" (Armstrong, Wall Street Journal, 7/19).


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