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. 2016 Dec;17(1):108.
doi: 10.1186/s10194-016-0701-2. Epub 2016 Dec 1.

The potential impact of primary headache disorders on stroke risk

Chia-Lin Tsai  1   2 , Chung-Hsing Chou  1   2 , Pei-Jung Lee  3 , Jiu-Haw Yin  1   4 , Shao-Yuan Chen  5   6   7 , Chun-Chieh Lin  1 , Yueh-Feng Sung  1 , Fu-Chi Yang  1 , Chi-Hsiang Chung  8   9   10 , Wu-Chien Chien  9   10 , Chia-Kuang Tsai  1 , Jiunn-Tay Lee  11   12
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The potential impact of primary headache disorders on stroke risk

Chia-Lin Tsai et al. J Headache Pain. 2016 Dec.

Abstract

Background: Headache such as migraine is associated with stroke. Studies focused on primary headache disorders (PHDs) as a risk factor for stroke are limited. The purpose of this population-based cohort study was to explore whether patients with PHDs were at a high risk for developing stroke.

Methods: A total of 1346 patients with PHDs were enrolled and compared with 5384 age-, gender- and co-morbidity-matched control cohorts. International Classification of Diseases, Clinical Modification codes were administered for the definition of PHDs, stroke, and stroke risk factors. Cox proportional-hazards regressions were performed for investigating hazard ratios (HR).

Results: PHDs patients exhibited a 1.49 times (95% CI :1.15-1.98, p < 0.01) higher risk for developing ischaemic stroke compared with that of control cohorts. Both migraine (HR = 1.22, 95% CI :1.13-1.97, p < 0.05) and tension-type headache (HR = 2.29, 95% CI :1.22-2.80, p < 0.01) were associated with an increased risk of ischemic stroke. Females with PHDs were at greater risk of developing ischaemic stroke (HR = 1.49, 95% CI :1.13-1.90, p < 0.01) than those without PHDs. PHDs patient aged 45 to 64 years displayed significantly higher risk to develop ischaemic stroke (HR = 1.50, 95% CI: 1.11-2.10, p < 0.05) than the matched controls. The impact of PHDs on ischaemic stroke risk became gradually apparent by different following time intervals beyond 2 years after first diagnosis.

Conclusion: PHDs is suggestive of an incremental risk for ischaemic stroke with gender-dependent, age-specific and time-dependent characteristics.

Keywords: Ischaemic stroke; Migraine; Non-migrainous headache; Risk factor; Tension-type headache.

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Figures

Fig. 1
Fig. 1
The cumulative incidence of ischemic stroke for the individual with and without primary headache disorders
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