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on August 6, 2009

Stroke. 2009
Published online before print August 6, 2009, doi: 10.1161/STROKEAHA.109.557462
A more recent version of this article appeared on October 1, 2009
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Submitted on May 8, 2009
Revised on June 17, 2009
Accepted on June 18, 2009

Relation of Candidate Genes that Encode for Endothelial Function to Migraine and Stroke. The Stroke Prevention in Young Women Study

Leah R. MacClellan PhD; Timothy D. Howard PhD; John W. Cole MD*; O. Colin Stine PhD; Wayne H. Giles MD; Jeffery R. O'Connell PhD; Marcella A. Wozniak MD; Barney J. Stern MD; Braxton D. Mitchell PhD; and Steven J. Kittner MD

From Department of Epidemiology and Preventive Medicine (L.R.M., O.C.S., B.D.M.), Department of Medicine (J.R.O., B.D.M.), Department of Neurology (J.W.C., M.A.W., B.J.S., S.J.K.), University of Maryland School of Medicine, Baltimore, Md; Wake Forest University School of Medicine (T.D.H.), Winston-Salem, NC; VA Maryland Health Care System (J.W.C., M.A.W., B.J.S., S.J.K.), Baltimore, Md; Centers for Disease Control and Prevention (W.H.G.), Atlanta, Ga.

* To whom correspondence should be addressed. E-mail: jcole{at}som.umaryland.edu.

Background and Purpose—Migraine with aura is a risk factor for ischemic stroke, but the mechanism by which these disorders are associated remains unclear. Both disorders exhibit familial clustering, which may imply a genetic influence on migraine and stroke risk. Genes encoding for endothelial function are promising candidate genes for migraine and stroke susceptibility because of the importance of endothelial function in regulating vascular tone and cerebral blood flow.

Methods—Using data from the Stroke Prevention in Young Women study, a population-based case-control study including 297 women aged 15 to 49 years with ischemic stroke and 422 women without stroke, we evaluated whether polymorphisms in genes regulating endothelial function, including endothelin-1 (EDN), endothelin receptor type B (EDNRB), and nitric oxide synthase-3 (NOS3), confer susceptibility to migraine and stroke.

ResultsEDN SNP rs1800542 and rs10478723 were associated with increased stroke susceptibility in whites (OR, 2.1; 95% CI, 1.1–4.2 and OR, 2.2; 95% CI, 1.1–4.4; P=0.02 and 0.02, respectively), as were EDNRB SNP rs4885493 and rs10507875, (OR, 1.7; 95% CI, 1.1–2.7 and OR, 2.4; 95% CI, 1.4–4.3; P=0.01 and 0.002, respectively). Only 1 of the tested SNP (NOS3 rs3918166) was associated with both migraine and stroke.

Conclusions—In our study population, variants in EDN and EDNRB were associated with stroke susceptibility in white but not in black women. We found no evidence that these genes mediate the association between migraine and stroke.


Key words: endothelium • ischemia • migraine • stroke in young adults