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11. Understanding risk factors

 What does my doctor  mean when she says I need to minimise my risk factors?

The sorts of things your doctor is concerned about are:

• Do you smoke?

• How much alcohol do you drink?

• Do you take regular exercise?

• What is your diet like?

– Is it low in fat?

– Is it high in fibre?

• Are you overweight?

• Is your blood pressure normal?

• What is your cholesterol?

– Do you have the right balance of good and bad cholesterol?

• What is your blood sugar?

These are all aspects of our life that may contribute to the development of disease. If you are overweight, you are at a greater risk of developing high blood pressure or diabetes. High blood pressure or diabetes may increase your chance of a heart attack – an event we

would all prefer to avoid.

Minimising your risk factors is making sure that your lifestyle is as healthy as possible so that you reduce the chance of developing a disease that may be potentially life-threatening.

I have migraine and want to go on the Pill. Why is my doctor so keen for me to stop smoking?

Your doctor wants to minimise the risk to you of going on the Pill.

Migraine is associated with an increased risk of stroke, and going on the Pill increases your risk of stroke. The biggest risk of stroke is smoking, so your doctor simply wants to make your going on the Pill as safe as possible from a medical risk perspective.

I am taking a triptan for my migraine but my doctor says I have to stop it until my blood pressure is under control. Why?

Araised blood pressure can lead to a variety of medical conditions, one of which is a heart attack or stroke. Triptans work by causing blood vessels to constrict and narrow. If your blood pressure remains untreated, this could lead to vessel damage – which is magnified when you take your triptan to treat your migraine and could theoretically cause a heart attack or stroke.

Your doctor wants to minimize the risk of this happening. Getting your blood pressure under control minimises your risk of these other conditions developing and allows you to treat your migraine effectively and safely again.

I have a strong family history of heart attack, and a lot of my family gets migraine. What sort of risk factors should I think about?

You need to think about your cholesterol levels, especially your balance of good and bad cholesterol. If you smoke, you should stop; if you are overweight, you should think about trying to lose some weight. These steps will reduce your risk of both heart attack (a potential risk associated with your family history) and stroke (a potential risk associated with your migraine).

You might want to think about a low GI diet, which is said to aid weight loss, as is regular exercise. These are all things that can reduce the risk to you of a heart attack happening.

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