Getting migraine headaches is bad enough. Now a new study of 620 migraine sufferers from the Netherlands has found that patients whose migraine headaches are preceded by a visual disturbance (aura) are significantly more likely to have risk factors for coronary heart disease.

Compared to people without headaches, those with migraine attacks that followed an aura have a 43 percent greater chance of having elevated total cholesterol levels and 76 percent greater likelihood of having high blood pressure. These individuals also had a fourfold increase in their incidence of coronary heart disease or a stroke before the age of 45. Their risk was further worsened because they were more likely to smoke cigarettes and to have parents who’d had a heart attack or stroke.

There is no clear explanation for this association between migraine headaches and risks for coronary disease, but the findings suggest that people with migraine headache pains should also take extra pains to identify and try to correct any controllable risk factors they might have.