Nagai Tokihisa, Tabara Yasuharu, Igase Michiya, Nakura Jun, Miki Tetsuro, Kohara Katsuhiko
Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Toon, Japan.
Hypertens Res. 2007 Jul;30(7):577-83. doi: 10.1291/hypres.30.577.
Migraine is a common subtype of headache. Epidemiological studies have revealed that migraine could be an independent risk factor for ischemic stroke even in elderly subjects. Arterial stiffness is one of the major pathophysiological bases of stroke. In the present study, we cross-sectionally investigated the possible relationship between migraine and arterial stiffness in community-dwelling subjects. The study subjects were independently recruited from two sources (Group A, n=134, 68+/-5 years; Group B, n=138, 68+/-7 years). Augmentation index (AI), the ratio of augmented pressure by the reflection pressure wave to the pulse pressure, was obtained from the radial arterial waveform as an index of arterial stiffness. Brachial blood pressure was also measured simultaneously. Migraine was diagnosed using a previously validated questionnaire. The prevalence of migraine was 5.2% (Group A) and 16.7% (Group B). Subjects with migraine had higher radial AI in both Group A (migraine, 101+/-15%; other headache, 88+/-12%; no headache, 86+/-12%, p=0.003) and Group B (95+/-11%, 90+/-11%, 91+/-14%, p=0.058). Multiple linear regression analysis revealed that migraine was an independent determinant of AI (beta=0.154, p=0.002) after adjustment for other confounding factors: age (beta=-0.024, p=0.654); sex (beta=0.141, p=0.069); body height (beta=-0.215, p=0.005); systolic blood pressure (beta=0.174, p=0.001); medication for hypertension, hyperlipidemia, and diabetes mellitus (beta=-0.014, p=0.787); and heart rate (beta=-0.539, p<0.001). In a separate analysis by sex, migraine was also a significant determinant for AI (male, beta=0.246, p=0.019; female, beta=0.159, p=0.008). Migraine in the elderly could be a clinical manifestation of enhanced arterial stiffness.
偏头痛是头痛的一种常见亚型。流行病学研究表明,即使在老年人群中,偏头痛也可能是缺血性中风的独立危险因素。动脉僵硬度是中风的主要病理生理基础之一。在本研究中,我们对社区居住人群中偏头痛与动脉僵硬度之间的可能关系进行了横断面调查。研究对象分别来自两个独立来源(A组,n = 134,68±5岁;B组,n = 138,68±7岁)。从桡动脉波形获取增强指数(AI),即反射压力波引起的增强压力与脉压之比,作为动脉僵硬度的指标。同时测量肱动脉血压。使用先前验证过的问卷诊断偏头痛。偏头痛的患病率在A组为5.2%,在B组为16.7%。在A组(偏头痛组,101±15%;其他头痛组,88±12%;无头痛组,86±12%,p = 0.003)和B组(95±11%,90±11%,91±14%,p = 0.058)中,偏头痛患者的桡动脉AI均较高。多线性回归分析显示,在调整其他混杂因素后:年龄(β = -0.024,p = 0.654);性别(β = 0.141,p = 0.069);身高(β = -0.215,p = 0.005);收缩压(β = 0.174,p = 0.001);高血压、高脂血症和糖尿病用药情况(β = -0.014,p = 0.787);心率(β = -0.539,p < 0.001),偏头痛是AI的独立决定因素(β = 0.154,p = 0.002)。在按性别进行的单独分析中,偏头痛也是AI的显著决定因素(男性,β = 0.246,p = 0.019;女性,β = 0.159,p = 0.008)。老年人的偏头痛可能是动脉僵硬度增强的一种临床表现。