Population-Based Study Identifies Numerous Risk Factors for Migraine

A study presented at the American Neurological Association meeting, held October 13-15 in St. Louis, Missouri, identified vascular and nonvascular risk factors associated with migraine in a population-based study in an effort to help identify targets for reducing migraine-related disability.

Although migraine is known to present a significant healthcare burden, stemming from both direct and indirect utilization of healthcare resources, the authors wrote that a comprehensive review of risk factors is lacking. They performed a retrospective cross-sectional analysis of the Nationwide Inpatient Sample (NIS) for years 2013 to 2014 for adults over the age of 18 hospitalized in the United States. Univariate analysis was performed using the chi-square test to identify the prevalence of the risk factors, and a multivariate survey logistic regression analysis was performed to evaluate the odds of the prevalence of risk factors; researchers also conducted a weighted analysis and removed missing age, gender, and race data.

Of the total 56,499,788 hospitalizations, 983,065 (1.74%) patients had a primary or secondary diagnosis of migraine. Younger patients (mean age 48 vs 58), females (82.1% vs 58.5%; P <.0001), white patients (76.8% vs 70.5%; P <.0001), and privately insured patients (41.1% vs 27.4%; P <.0001) had a higher prevalence of migraine.

Compared with people without migraine, patients with migraine were significantly more likely to have:

• Hypertension (odds ratio [OR], 1.44; confidence interval [CI]: 1.43-1.46; 44.49% vs 52.84%)
• Recent transient ischemic attack (TIA) (OR, 3.13; CI: 3.02-3.25; 1.74% vs 0.67%)
• History of TIA (OR, 1.70; CI: 1.67-1.74; 5.88% vs 5.25%)
• Ischemic stroke (OR, 1.40; CI: 1.35-1.45; 2.06% vs 1.97%)
• Hemorrhagic stroke (OR, 1.11; CI: 1.04-1.19; 0.49% vs 0.46%)
• Obesity (OR, 1.46; CI: 1.44-1.48; 19.20% vs 13.56%)
• Hypercholesterolemia (OR, 1.33; CI: 1.30-1.36; 5.75% vs 5.54%)
• Substance abuse (OR, 1.51; CI: 1.48-1.54; 7.88% vs 4.88%)
• Past or current consumption of tobacco (OR, 1.40; CI: 1.38-1.41; 31.02% vs 27.39%)
• AIDS (OR, 1.13; CI: 1.04-1.24; 0.33% vs 0.41%)
• Hypocalcemia (OR, 1.09; CI: 1.03-1.14; 0.77% vs 0.89%)
• Vitamin D deficiency (OR, 1.93; CI: 1.88-1.99; 2.47% vs 1.37%)

Cerebral atherosclerosis, diabetes, ischemic heart disease, atrial fibrillation, and alcohol abuse were not significantly associated with migraine.

The authors said their results aid in identifying targets for migraine prevention as well as risk stratification in migraineurs.

Reference

Patel UK, Malik P, Hussain MR, et al. Vascular and non-vascular risk factors associated with migraine. Presented at: 144th Annual Meeting of the American Neurological Association; October 13-15, 2019; St. Louis, MO. Abstract S199.