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Liu H, Zhang S, Gong Z, Zhao W, Lin X, Liu Y, Wang S, Yu S, Dong Z. Association between migraine and cardiovascular disease mortality: A prospective population-based cohort study. Headache 2023; 63:1109-1118. [PMID: 37655645 DOI: 10.1111/head.14616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE The study assessed the association between migraine and cardiovascular disease (CVD) mortality in the US population. BACKGROUND Previous studies have drawn different conclusions about the association between migraine and CVD mortality based on different populations; therefore, it is important to explore the relationship between migraine and CVD mortality in the US population. METHODS This prospective cohort study included 10,644 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. Participants who reported having severe headache or migraine were classified as having migraine. Mortality data were obtained by linkage of the cohort database to the National Death Index as of December 31, 2019. Based on the International Classification of Diseases, Tenth Revision, CVD mortality includes the following disease codes: I00-I09 (acute rheumatic fever and chronic rheumatic heart diseases), I11 (hypertensive heart disease), I13 (hypertensive heart and renal disease), I20-I25 (ischemic heart diseases), I26-I28 (pulmonary embolism and other acute pulmonary heart diseases), I29 (various cardiovascular diseases caused by different reasons), I30-I51 (other forms of heart disease), and I60-I69 (cerebrovascular diseases). Data were analyzed from October to November 2022. RESULTS Among 10,644 adults included in the study (mean age, 46.4 [0.3] years, 5430 men [47.4%]), 2106 (20.4%) had migraine. During a median follow-up period of 201 months, there were 3078 all-cause deaths and 997 CVD deaths. Compared to individuals without migraine, those with migraine had an adjusted hazard ratio (HR) of 1.30 (95% confidence interval [CI], 1.04-1.62; p = 0.019) for CVD mortality and 1.23 (95% CI, 1.13-1.35; p < 0.001) for all-cause mortality. In subgroup analyses, migraine was associated with CVD mortality in participants who were women (HR, 1.43; 95% CI, 1.06-1.93), aged < 45 years (HR, 1.69; 95% CI, 1.04-2.76), non-Hispanic White (HR, 1.42; 95% CI, 1.09-1.86), those with a body mass index < 30 kg/m2 (HR, 1.36; 95% CI, 1.03-1.78), former or current smokers (HR, 1.36; 95% CI, 1.00-1.85), former or current alcohol drinkers (HR, 1.33; 95% CI, 1.03-1.72), and those without metabolic syndrome (HR, 1.31; 95% CI, 1.01-1.71). The association between migraine and CVD mortality was robust in sensitivity analyses, after excluding participants who died within 2 years of follow-up (HR, 1.31; 95% CI, 1.05-1.65) or those with a history of cancer at baseline (HR, 1.28; 95% CI, 1.01-1.62). CONCLUSIONS Migraine was associated with a higher CVD mortality rate in the US population.
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Affiliation(s)
- Huanxian Liu
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- International Headache Centre, Chinese PLA General Hospital, Beijing, China
| | - Shuhua Zhang
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- International Headache Centre, Chinese PLA General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Zihua Gong
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- International Headache Centre, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Wei Zhao
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- International Headache Centre, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Xiaoxue Lin
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- International Headache Centre, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Yingyuan Liu
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- International Headache Centre, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengyuan Yu
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- International Headache Centre, Chinese PLA General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
- Medical School of Chinese PLA, Beijing, China
| | - Zhao Dong
- Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
- International Headache Centre, Chinese PLA General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
- Medical School of Chinese PLA, Beijing, China
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Zhang S, Cao Y, Yan F, Chen S, Gui W, Hu D, Liu H, Li H, Yu R, Wei D, Wang X, Wang R, Chen X, Zhang M, Ran Y, Jia Z, Han X, He M, Liu J, Yu S, Dong Z. Similarities and differences between SUNCT and SUNA: a cross-sectional, multicentre study of 76 patients in China. J Headache Pain 2022; 23:137. [PMID: 36289482 PMCID: PMC9609258 DOI: 10.1186/s10194-022-01509-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/17/2022] [Indexed: 11/25/2022] Open
Abstract
Background Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) have not been evaluated sufficiently due to limited data, particularly in China. Methods Patients with SUNCT or SUNA treated in a tertiary headache centre or seven other headache clinics of China between April 2009 and July 2022 were studied; we compared their demographics and clinical phenotypes. Results The 45 patients with SUNCT and 31 patients with SUNA had mean ages at onset of 37.22 ± 14.54 years and 42.45 ± 14.72 years, respectively. The mean ages at diagnosis of SUNCT and SUNA were 41.62 ± 12.70 years and 48.68 ± 13.80 years, respectively (p = 0.024). The correct diagnosis of SUNCT or SUNA was made after an average of 2.5 (0–20.5) years or 3.0 (0–20.7) years, respectively. Both diseases had a female predominance (SUNCT: 1.14:1; SUNA: 2.10:1). The two diseases differed in the most common attack site (temporal area in SUNCT, p = 0.017; parietal area in SUNA, p = 0.002). Qualitative descriptions of the attacks included stabbing pain (44.7%), electric-shock-like pain (36.8%), shooting pain (25.0%), and slashing pain (18.4%). Lacrimation was the most common autonomic symptom in both SUNCT and SUNA patients, while eyelid oedema, ptosis, and miosis were less frequent. Triggers such as cold air and face washing were shared by the two diseases, and they were consistently ipsilateral to the attack site. Conclusions In contrast to Western countries, SUNCT and SUNA in China have a greater female predominance and an earlier onset. The shared core phenotype of SUNCT and SUNA, despite their partial differences, suggests that they are the same clinical entity.
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Affiliation(s)
- Shuhua Zhang
- grid.216938.70000 0000 9878 7032School of Medicine, Nankai University, Tianjin, 300071 China ,grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Ya Cao
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Fanhong Yan
- Department of Neurology, Linyi Jinluo Hospital, Linyi, Shandong China
| | - Sufen Chen
- grid.452210.0Department of Neurology, Changsha Central Hospital Affiliated to University of South China, Changsha, Hunan China
| | - Wei Gui
- grid.59053.3a0000000121679639Department of Neurology, The First Affiliated Hospital of USTC, Hefei, Anhui China
| | - Dongmei Hu
- grid.410638.80000 0000 8910 6733Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong China
| | - Huanxian Liu
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Hongjin Li
- Department of Neurology, Dong E Hospital, Liaocheng, Shandong China
| | - Rongce Yu
- Department of Neurology, People’s Hospital of Luanchuan, Luoyang, Henan China
| | - Dan Wei
- grid.410609.aDepartment of Neurology, Wuhan No.1 Hospital of China Hubei Province, Wuhan, Hubei China
| | - Xiaolin Wang
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Rongfei Wang
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Xiaoyan Chen
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Mingjie Zhang
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Ye Ran
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Zhihua Jia
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Xun Han
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Mianwang He
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Jing Liu
- grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Shengyuan Yu
- grid.216938.70000 0000 9878 7032School of Medicine, Nankai University, Tianjin, 300071 China ,grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Zhao Dong
- grid.216938.70000 0000 9878 7032School of Medicine, Nankai University, Tianjin, 300071 China ,grid.414252.40000 0004 1761 8894Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894International Headache Centre, Department of Neurology, Chinese PLA General Hospital, Beijing, 100853 China
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