Elevated blood pressure and headache disorders in China – associations, under-treatment and implications for public health

The Journal of Headache and Pain

Research Article

Xiutang Cao¹  Xiangyang Qiao²  Ruozhuo Liu³  Shengyuan Yu³  Mianwang He³  Jiachun Feng⁴  Xiaosu Yang⁵  Gang Zhao⁶  Timothy J. Steiner⁷  Yannan Fang⁸ 

[1] Department of Health and Economics, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, 100853, Beijing, China;Department of Neurology, Affiliated Huashan Hospital of Fudan University, Urumqi Middle Road 12, 200040, Shanghai, China;Department of Neurology, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, 100853, Beijing, China;Department of Neurology, The First Hospital of Jilin University, Xinmin Street 71, 130021, Changchun, Jilin Province, China;Department of Neurology, Xiangya Hospital, Central-South University, Xiangya Road 87, 410008, Changsha, Hunan Province, China;Department of Neurology, Xijing Hospital, The Fourth Military Medical University, Changle West Road 15, 710032, Xian, Shaanxi Province, China;Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway;Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, The Second Zhongshan Road 58, 510080, Guangzhou, Guangdong Province, China;

关键词: Headache;    Hypertension;    Public health;    Population-based survey;    China;    Global campaign against headache;   

DOI  :  10.1186/s10194-015-0570-0

 received in 2015-08-21, accepted in 2015-09-29,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundBoth hypertension (HTN) and headache disorders are highly prevalent worldwide. Our purpose, in a nationwide study of the Chinese general population, was to evaluate any association between primary headache disorders and elevated blood pressure (eBP). We could not collect data on antihypertensive therapy, but took the view that, whatever such therapy might be taken, eBP was a sign that it was failing to meet treatment needs. Therefore, as a secondary purpose, important from the public-health perspective, we would present the prevalence of eBP (treated or not) as indicative of unmet health-care need in China.MethodsThis was a questionnaire-based nationwide cross-sectional door-to-door survey using cluster random-sampling, selecting one adult (18–65 years) per household. Headache was diagnosed by ICHD-II criteria and eBP as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Chi-squared test and multivariate logistic regression analysis were used to assess the strength and significance of associations. We set significance at P ≤ 0.05.ResultsOf 5,041 survey participants (participation rate 94.1 %), 154 were excluded because of missing BP data, leaving 4,987 for analysis [mean age: 43.6 ± 12.8 years; male 2,532 (mean age: 43.4 ± 12.9 years); female 2,455 (mean age 43.9 ± 12.8 years)]. There were 466 participants with migraine, 535 with tension type headache (TTH) and 48 with all causes of headache on ≥15 days/month. The prevalence of eBP was 22.1 % (males 22.9 %, females 21.3 %). No associations of eBP with any of the headache disorders survived multivariate adjusted analysis. The demographic and anthropometric variables most strongly associated with eBP were higher age (AOR 3.7) and being overweight (AOR 2.4), seen in both genders. Less strong were male gender, lower educational level and urban habitation.ConclusionsWe found no clear-cut associations between eBP and any headache disorder. The associations with demographic and anthropometric variables may have acted as confounders in past reports to the contrary. We did find an alarmingly high prevalence of eBP, recognizing that this signals substantial under-treatment in China of a serious condition, and therefore a major public-health concern.

【 授权许可】

CC BY   
© He et al. 2015