4. Discussion
hypercoagulability, head injury, stroke, Parkinson’s disease, Hypertension, headache, migraines, migraine, aura, cerebral microcirculatory vasoconstriction, hypertension, migraine infarction, migraineurs [, strokes
HYPERCOAGULABILITY, STROKE, DISORDERS, HYPERTENSION, MIGRAINES, MIGRAINE, HYPERTENSION, HIGH BLOOD PRESSURE, CORONARY ARTERY DISEASE, STROKES
Our study attempted to use a large real-world dataset with long-term follow-up to determine whether acupuncture treatment could significantly reduce the risk of stroke development in migraineurs. The results of the study found that acupuncture treatment reduces the risk of strokes in patients with migraines by approximately 60%, showing that this treatment method has a good protective effect against strokes.The Taiwanese government started creating the country’s NHI program in 1995 to cover the entire public insurance system. At present, NHI coverage reaches more than 99% of the 23 million residents of Taiwan. The NHI program includes both Western and traditional Chinese medicine and provides representative and empirical health insurance data for use in research [We found no difference in stroke risk between women and men. This appears to contradict many previous studies on migraines and strokes, which reported a predominance of stroke risks in women [In our study, among the listed comorbidities that were associated with migraines, hypertension, coronary artery disease, head injury, Parkinson’s disease, and mental disorders were independently found to significantly increase the risk of stroke. Hypertension is the most common risk factor for stroke, high blood pressure can increase the risk of strokes by four times, and routine blood pressure management is very important [Although the mechanisms by which migraines increase the risk of strokes are not fully understood, several associated pathological mechanisms have been discovered. One study suggested that migraines may directly cause migraine infarction by inducing cerebral microcirculatory vasoconstriction, cerebral large vessel spasms, and vascular endothelial-related hypercoagulability [Our present study clearly illustrates that acupuncture complements modern medical treatment to bring about a reduced incidence of stroke development in patients with migraines. The question then arises of how acupuncture is able to achieve such an effect. In the future, more basic experiments should be conducted to clarify the mechanism of action of acupuncture to support our clinical data.Our study had several limitations. (1) The effect of acupuncture treatment on the risk of strokes in migraine patients of different degrees was not explored. Quantifications of actual severity and frequency of headache attacks in migraineurs were not recorded in the NHIRD medical records. However, the subcategories of migraine ICD codes, such as refractory migraine, non-refractory migraine, episodic migraine, and chronic migraine, could guide further research on this topic. In addition, we did not clarify the association between the number, frequency, timing, and duration of acupuncture treatment in patients with migraines and the risk of a stroke. Future studies could examine the differences in the risk of strokes among patients receiving acupuncture for the first time versus those who have tried other medications, or compare the stroke risk of patients with acupuncture–refractory migraines versus the stroke risk of patients with non-refractory migraines. Furthermore, aura is a clear risk factor for strokes in migraineurs [