The "aura" that immediately precedes a migraine affects sufferers differently, with some combination of dizziness, flashes or spots of light, and temporary loss of vision, according to Reuters.
Among the 28 million Americans, mostly women, who suffer migraines, fewer than one-third experience the aura beforehand that was linked in the study to the increased risk of heart attack or stroke.
Though the risk of stroke or heart problems was double among migraine suffers with aura, the problems can take a long time to appear and there are more significant risk factors such as smoking and high cholesterol, according to the five-year study of 5,125 women aged 45 or older.
The Journal of the American Medical Association study found women who had migraines without aura were not at increased risk.
There is also concern that all six of the study's authors have done consulting work or received research funding from makers of treatments for migraines or heart-related problems, according to BBC News.
Migraine can affect people at any age but it is most prevalent between the ages of 20 and 50 and two thirds of sufferers are women. The condition can run in families.
Previous research had shown migraines with aura were linked with strokes caused by blood clots.