The potential impact of primary headache disorders on stroke risk |
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| Authors: | Chia-Lin Tsai Chung-Hsing Chou Pei-Jung Lee Jiu-Haw Yin Shao-Yuan Chen Chun-Chieh Lin Yueh-Feng Sung Fu-Chi Yang Chi-Hsiang Chung Wu-Chien Chien Chia-Kuang Tsai Jiunn-Tay Lee |
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| Affiliation: | 1.Department of Neurology, Tri-Service General Hospital,National Defense Medical Center,Taipei,Taiwan, Republic of China;2.Graduate Institute of Medical Sciences,National Defense Medical Center,Taipei,Taiwan, ROC;3.Departments of Nursing, Tri-Service General Hospital,National Defense Medical Center,Taipei,Taiwan, ROC;4.Division of Neurology, Department of Medicine,Cheng Hsin General Hospital,Taipei,Taiwan, ROC;5.Department of Neurology,Cardinal Tien Hospital,New Taipei City,Taiwan, ROC;6.Department of Hyperbaric Medicine,Cardinal Tien Hospital,New Taipei City,Taiwan, ROC;7.School of Medicine,Fu-Jen Catholic University,New Taipei City,Taiwan, ROC;8.Taiwanese Injury Prevention and Safety Promotion Association,Taipei,Taiwan, ROC;9.School of Public Health, National Defense Medical Center,Taipei,Taiwan, ROC;10.Department of Medical Research, Tri-Service General Hospital,National Defense Medical Center,Taipei,Taiwan, ROC |
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| Abstract: | BackgroundHeadache 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.MethodsA 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).ResultsPHDs 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.ConclusionPHDs is suggestive of an incremental risk for ischaemic stroke with gender-dependent, age-specific and time-dependent characteristics. |
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