偏头痛与绝经后高血压事件的相关性：一项纵向队列研究。
Association of Migraine With Incident Hypertension After Menopause: A Longitudinal Cohort Study.
机构信息
From Center for Research in Epidemiology and Population Health (CESP) (C.J.M., D.E.F., A.-L.M., G.S., M.-C.B.-R.), Institut Gustave Roussy, INSERM (Institut National de la Santé et de la Recherche Médicale) U1018; Université Paris-Saclay (C.J.M., D.E.F., A.-L.M., G.S., M.-C.B.-R.), Université Paris-Sud, Villejuif; EA 2694-Santé Publique: Épidémiologie et Qualité des Soins (A.-L.M.), Université de Lille, CHU Lille, France; Deep Digital Phenotyping Research Unit, Department of Population Health (G.F.), Luxembourg Institute of Health, Strassen; Institute of Public Health Charité-Universitätsmedizin Berlin (T.K.), Germany; and Department of Statistics, Computer Science and Applications (DISIA) (G.S.), University of Florence, Italy.
出版信息
Neurology. 2021 Jul 6;97(1):e34-e41. doi: 10.1212/WNL.0000000000011986. Epub 2021 Apr 21.
OBJECTIVE
Migraine has been identified as a potential risk factor for hypertension in prospective studies. In women, migraine prevalence decreases after menopause, but no studies have determined whether migraine is associated with hypertension after menopause. This study sought to determine whether history of migraine was associated with an increased risk of hypertension among menopausal women.
METHODS
We assessed associations between migraine and hypertension in a longitudinal cohort study of 56,202 menopausal women participating in the French E3N cohort, with follow-up beginning in 1993. We included women who did not have hypertension or cardiovascular disease at the time of menopause. Migraine was classified as ever or never at each questionnaire cycle. Cox proportional hazards models were used to investigate relations between migraine and hypertension, controlling for potential confounding. A secondary analysis with baseline in 2011 considered aura status, grouping participants reporting migraine as migraine with aura, migraine without aura, or unknown migraine type.
RESULTS
During 826,419 person-years, 12,501 cases of incident hypertension were identified, including 3,100 among women with migraine and 9,401 among women without migraine. Migraine was associated with an increased risk of hypertension in menopausal women (hazard ratio [HR] 1.29 [95% confidence interval 1.24, 1.35]) and was consistent in post hoc sensitivity analyses, such as when controlling for common migraine medications. Associations between migraine and hypertension were similar whether or not women reported aura (HR 1.54 [1.04, 2.30], HR 1.32 [0.87, 2.02], heterogeneity 0.60). Associations were slightly stronger among ever users of menopausal hormone therapy (HR 1.34 [1.27, 1.41]) than among never users (HR 1.19 [1.11, 1.28]).
CONCLUSIONS
Migraine was associated with an increased risk of hypertension among menopausal women. In secondary analysis, we did not observe a significant difference between migraine with aura and migraine without aura.
目的
前瞻性研究表明偏头痛是高血压的潜在危险因素。女性绝经后偏头痛的患病率降低，但尚无研究确定偏头痛与绝经后高血压是否相关。本研究旨在确定偏头痛病史是否与绝经后女性高血压风险增加相关。
方法
我们在法国 E3N 队列研究中评估了偏头痛与高血压之间的关系，该研究纳入了 56202 名参与研究的绝经后女性，随访始于 1993 年。我们纳入了在绝经时无高血压或心血管疾病的女性。偏头痛在每个问卷调查周期中分为有或无。使用 Cox 比例风险模型调查偏头痛与高血压之间的关系，同时控制潜在混杂因素。二次分析以 2011 年为基线，考虑先兆状态，将报告偏头痛的参与者分为有先兆偏头痛、无先兆偏头痛或未知偏头痛类型。
结果
在 826419 人年期间，共发生了 12501 例新发高血压，其中 3100 例发生在有偏头痛的女性中，9401 例发生在无偏头痛的女性中。偏头痛与绝经后女性高血压风险增加相关（风险比 [HR] 1.29 [95%置信区间 1.24，1.35]），且在事后敏感性分析中一致，例如在控制常见偏头痛药物后。偏头痛与高血压之间的关联在有或无先兆的女性中相似（HR 1.54 [1.04，2.30]，HR 1.32 [0.87，2.02]，异质性 0.60）。在曾使用绝经激素治疗的女性中（HR 1.34 [1.27，1.41]），偏头痛与高血压之间的关联强于从未使用者（HR 1.19 [1.11，1.28]）。
结论
偏头痛与绝经后女性高血压风险增加相关。在二次分析中，我们未观察到有先兆偏头痛和无先兆偏头痛之间存在显著差异。
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