Migraine prevalence, disease burden, and the need for preventive therapy
Migraine prevalence, disease burden, and the need for preventive therapy
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DOI：
10.1212/01.wnl.0000252808.97649.21
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发表时间：
2007-01-30
期刊：
影响因子：
9.9
通讯作者：
Stewart, W. F.
中科院分区：
文献类型：
--
作者：
Lipton, R. B.;Bigal, M. E.;Stewart, W. F.
目的：1)重新评估美国偏头痛的患病率；2)评估人群偏头痛治疗模式；3)将目前预防性治疗的使用模式与专家头痛小组的建议进行对比。方法：邮寄一份有效的自我管理头痛问卷给120,000个美国家庭，代表美国人口。偏头痛是根据国际头痛疾病分类第二版的标准确定的。预防用药指南是由一个头痛专家小组制定的。考虑或提供预防的标准是基于头痛的频率和损害。结果：我们评估了162,576名12岁或以上的个体。偏头痛的1年患病率为11.7%（女性17.1%，男性5.6%）。患病率在中年达到顶峰，在青少年和60岁以上人群中较低。在所有偏头痛患者中，31.3%的人发作频率为每月三次或更多，53.7%的人报告严重损伤或需要卧床休息。总的来说，25.7%符合“提供预防”的标准，另外13.1%应该考虑预防。只有13.0%的人报告目前每天使用预防偏头痛的药物。结论：与以前的研究相比，在过去的15年中，美国偏头痛的流行病学概况保持稳定。四分之一以上的偏头痛患者可以接受预防治疗，而很大一部分可能从预防中受益的人却没有得到治疗。
Objectives: 1) To reassess the prevalence of migraine in the United States; 2) to assess patterns of migraine treatment in the population; and 3) to contrast current patterns of preventive treatment use with recommendations for use from an expert headache panel. Methods: A validated self-administered headache questionnaire was mailed to 120,000 US households, representative of the US population. Migraineurs were identified according to the criteria of the second edition of the International Classification of Headache Disorders. Guidelines for preventive medication use were developed by a panel of headache experts. Criteria for consider or offer prevention were based on headache frequency and impairment. Results: We assessed 162,576 individuals aged 12 years or older. The 1-year period prevalence for migraine was 11.7% (17.1% in women and 5.6% in men). Prevalence peaked in middle life and was lower in adolescents and those older than age 60 years. Of all migraineurs, 31.3% had an attack frequency of three or more per month, and 53.7% reported severe impairment or the need for bed rest. In total, 25.7% met criteria for "offer prevention," and in an additional 13.1%, prevention should be considered. Just 13.0% reported current use of daily preventive migraine medication. Conclusions: Compared with previous studies, the epidemiologic profile of migraine has remained stable in the United States during the past 15 years. More than one in four migraineurs are candidates for preventive therapy, and a substantial proportion of those who might benefit from prevention do not receive it.