A Review of the Vascular Pathophysiology of Migraine: Should We Consider Statins as a Treatment Option?

INTRODUCTION/OBJECTIVE: Migraine is a primary headache disorder that affects more than a billion people worldwide and can severely impact quality of life. Inflammation and endothelial dysfunction in the trigeminovascular system are the suggested underlying mechanisms. Statins, beyond their lipid-lowering effects, exhibit pleiotropic properties including anti-inflammatory, antioxidative, and endothelial-modulating effects, which may be relevant to migraine pathophysiology. This narrative review evaluates current evidence on the efficacy of statins in migraine prophylaxis, treatment, and prevention of associated vascular events. METHODS: A literature search was conducted using MEDLINE (via PubMed) for English-language articles published between 1997 and June 2026 using the terms "migraine," "statins," "pathophysiology of migraine," "neuroinflammation," and "migraine treatment". RESULTS: The majority of studies endorse the use of statins in individuals with migraines, noting that their positive impact on migraines and cardiovascular risk outweighs any adverse effects. DISCUSSION: Considering the increased cardiovascular risk in migraine sufferers compared with those without migraine, statins may play a beneficial role in both migraine management and cardiovascular risk reduction. It is surprising that the role of statins in a common disease like migraine, which is also associated with an increased risk of vascular events, does not include definitive evidence. CONCLUSION: Statins might be considered for migraine treatment and prevention in individuals with chronic migraine, aura, hyperlipidemia, hypertension, a family history of cardiovascular disease, or other cardiovascular risk factors. We hope that the present article will encourage further research to establish if statins have a definite role in the treatment of migraine.