Hypertension is a factor associated with chronic daily headache
Hypertension is a factor associated with chronic daily headache
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DOI：
10.1007/s10072-010-0322-5
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发表时间：
2010-06-01
影响因子：
3.3
通讯作者：
Padovani, A.
中科院分区：
文献类型：
--
作者：
Gipponi, S.;Venturelli, E.;Padovani, A.
慢性每日头痛（CDH）是主要三级保健中心最常见的头痛综合征之一。CDH被定义为每月发生15天以上的头痛。CDH的发展涉及不同的机制，但具体是哪些因素导致了从偶发性到CDH的转变，在很大程度上仍然未知。镇痛药的过度使用通常被认为是这种转变的最重要因素。高血压、过敏、哮喘、关节炎、糖尿病、肥胖和甲状腺功能减退均与CDH相关。本研究的目的是确定慢性头痛患者的危险因素。共研究了1483例连续患者。我们收集了年龄、性别、头痛类型和合并症的信息。将患者分为3个诊断组：偏头痛和紧张性头痛（CTT）诊断依据ICHD-II， CDH诊断依据Silberstein和Lipton所描述的慢性日常头痛建议分类（《慢性日常头痛包括转化型偏头痛、慢性紧张性头痛和药物过度使用》，2001）。我们采用描述性统计和卡方检验。我们的数据显示，三组患者的年龄、性别和头痛发作情况相似。糖尿病、高胆固醇血症、吸烟和心脏病患病率在三组间无显著差异（P < 0.05）。CDH组高血压患病率（16.2%）明显高于其他两组（偏头痛7.3%,CTT 6.6%, P < 0.01）。合并用药与未合并用药的CDH患者高血压患病率差异无统计学意义（P < 0.05）。CDH患者（平均年龄41.8 +/- a14岁）转到头痛中心的时间晚于偏头痛和CTT患者（平均年龄37 +/- a12岁）（P < 0.05）。根据以往的研究，我们发现高血压在CDH中比在偏头痛和CTT中更常见。检查这一结果可以得出结论，CDH和高血压之间存在关联，但不一定存在因果关系。考虑到其他身体状况，我们没有发现任何相关性。躯体共病在CDH中的潜在作用有待于进一步的临床试验研究。
Chronic daily headache (CDH) is one of the more frequently observed headache syndromes at major tertiary care centers. CDH is defined as headache occurring > 15 days/month. Different mechanisms are involved in the development of CDH but what factors specifically contributing to the transformation from episodic into CDH remain largely unknown. Analgesic overuse is commonly identified as the most important factor for such transformation. Hypertension, allergy, asthma, arthritis, diabetes, obesity and hypothyroidism were associated with CDH in clinical series. The objective of this study is to identify risk factors of chronicity in patients with headache. A total of 1,483 consecutive patients were studied. We collected information on age, gender, headache type and comorbidity. Patients were divided into three diagnostic groups: migraine and tension-type headache (CTT) diagnosis were made according to ICHD-II, and CDH fulfilling the Proposal Headache Classification for Chronic Daily Headache described by Silberstein and Lipton (in Chronic daily headache including transformed migraine, chronic tension-type headache, and medication overuse, 2001). We used descriptive statistics and Chi-square test. Our data show that age, gender and headache onset were similar in the three groups. Diabetes, hypercolesterolaemia, smoke and cardiopathy prevalence did not differ in the three groups (P > 0.05). Hypertension prevalence in CDH group (16.2%) was significantly higher than in the other two groups (migraine 7.3%; CTT 6.6%; P < 0.01). There were no differences (P > 0.05) in hypertension prevalence between CDH with and without medication overuse. CDH patients (mean age 41.8 +/- A 14) referred to the Headache Center later than migraine and CTT patients (mean age 37 +/- A 12) (P > 0.05). According to previous studies we found that hypertension is more frequent in CDH than in migraine and CTT. Examining this result it is possible to conclude that there exists an association between CDH and hypertension, but not that a causal relationship necessarily exists. Considering the other somatic conditions we did not find any correlation. The potential role of somatic comorbidity in CDH has to be studied in further clinical trials.