The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies
The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies
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DOI：
10.1111/head.13281
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发表时间：
2018-04-01
期刊：
影响因子：
5
通讯作者：
Loder, Elizabeth
中科院分区：
文献类型：
--
作者：
Burch, Rebecca;Rizzoli, Paul;Loder, Elizabeth
背景和目标。在这项有针对性的系统综述中，我们旨在从基于人群的美国政府调查中确定成人偏头痛和严重头痛的最新患病率估计。我们的目的是评估患病率随时间的稳定性，并确定与偏头痛和其他严重头痛疾病的负担和治疗相关的其他信息。我们从国家健康访谈调查（NHIS）、国家医院门诊医疗调查（NHAMCS）和国家门诊医疗调查（NAMCS）中检索了最新的公开统计数据。我们从每项研究中提取和总结数据，并将其作为人口变量的函数。-美国成年人中自我报告的偏头痛和严重头痛的患病率和负担很高，在3个月的时间里，大约每6个美国人中就有1个受到影响，每5个女性中就有1个受到影响（总体为15.3% [95% CI 14.75-15.85]，男性为9.7% [95% CI 9.05-10.35]，女性为20.7% [95% CI 19.84-21.56]）。在19年的时间里，发病率一直非常稳定。与白人、黑人或西班牙裔相比，2015年美国印第安人或阿拉斯加原住民的偏头痛或严重头痛患病率最高（18.4%），亚洲人的患病率最低（11.3%）。18-44岁人群（17.9%）、失业人群（21.4%）、家庭年收入低于3.5万美元的人群（19.9%）、老年人和残疾人（16.4%）的偏头痛负担较高。头痛一直是急诊室就诊的第四或第五大常见原因，约占每年所有急诊室就诊人数的3%。在育龄妇女中，头痛是急诊科就诊的第三大原因。-严重头痛和偏头痛仍然是重要的公共卫生问题，对妇女，特别是育龄妇女和其他历史上处于不利地位的人口群体来说更为常见和负担沉重。如果最需要的人无法获得新的高成本治疗，这种不公平现象可能会加剧。
Background and Objectives.-In this targeted systematic review, we aimed to identify up-to-date prevalence estimates of migraine and severe headache in adults from population-based US government surveys. Our goal was to assess the stability of prevalence estimates over time, and to identify additional information pertinent to the burden and treatment of migraine and other severe headache conditions.Methods.-We searched for the most current publicly available summary statistics from the National Health Interview Survey (NHIS), the National Hospital Ambulatory Medical Care Survey (NHAMCS), and the National Ambulatory Medical Care Survey (NAMCS). We extracted and summarized data from each study over time and as a function of demographic variables.Results.-The prevalence and burden of self-reported migraine and severe headache in the US adult population is high, affecting roughly 1 out of every 6 American and 1 in 5 women over a 3-month period (15.3% overall [95% CI 14.75-15.85], 9.7% of males [95% CI 9.05-10.35] and 20.7% of females [95% CI 19.84-21.56]). The prevalence has been remarkably stable over a period of 19 years. The prevalence of migraine or severe headache in 2015 was highest in American Indian or Alaska Natives (18.4%) compared with whites, blacks, or Hispanics, with the lowest prevalence in Asians (11.3%). There is a higher burden of migraine in those aged 18-44 (17.9%), people who are unemployed (21.4%), those with family income less than $35,000 per year (19.9%), and the elderly and disabled (16.4%). Headache is consistently the fourth or fifth most common reason for visits to the emergency department, accounting for roughly 3% of all emergency department visits annually. In reproductive aged women, headache is the third leading cause of emergency department visits.Conclusions.-Severe headache and migraine remain important public health problems that are more common and burdensome for women, particularly women of childbearing age, and other historically disadvantaged segments of the population. These inequities could be exacerbated if new high-cost treatments are inaccessible to those who need them most.