偏头痛与心房颤动风险：基于特隆赫姆健康研究的 9 年随访。

Migraine and risk of atrial fibrillation: A 9-year follow-up based on the Trøndelag Health Study.

机构信息

Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.

NorHEAD - Norwegian Centre for Headache Research, NTNU, Trondheim, Norway.

出版信息

Cephalalgia. 2024 May;44(5):3331024241254517. doi: 10.1177/03331024241254517.

DOI:10.1177/03331024241254517

PMID:38808530

Abstract

BACKGROUND

Data from some population-based studies have indicated an increased risk of atrial fibrillation (AF) among patients with migraine, particularly among individuals with migraine with aura. The present study aimed to assess the association between primary headache disorders and AF.

METHODS

In a population-based 9-year follow-up design, we evaluated the questionnaire-based headache diagnosis, migraine and tension-type headache (TTH) included, collected in the Trøndelag Health Study (HUNT3) conducted in 2006-2008, and the subsequent risk of AF in the period until December 2015. The population at risk consisted of 39,340 individuals ≥20 years without AF at HUNT3 baseline who answered headache questionnaire during HUNT3. The prospective association was evaluated by multivariable Cox proportional hazard models with 95% confidence intervals (CIs).

RESULTS

Among the 39,340 participants, 1524 (3.8%) developed AF during the 9-year follow up, whereof 91% of these were ≥55 years. In the multivariable analyses, adjusting for known confounders, we did not find any association between migraine or TTH and risk of AF. The adjusted hazard ratios (HRs) were respectively 0.84 (95% CI = 0.64-1.11) for migraine, 1.16 (95% CI = 0.86-1.27) for TTH and 1.04 (95% CI = 0.86-1.27) for unclassified headache. However, in sensitivity analyses of individuals aged ≥55 years, a lower risk of AF was found for migraine (HR = 0.53; 95% CI = 0.39-0.73).

CONCLUSIONS

In this large population-based study, no increased risk of AF was found among individuals with migraine or TTH at baseline. Indeed, among individuals aged ≥55 years, migraine was associated with a lower risk for AF.

摘要

背景

一些基于人群的研究数据表明，偏头痛患者发生房颤（AF）的风险增加，尤其是有先兆偏头痛患者。本研究旨在评估原发性头痛障碍与 AF 之间的关系。

方法

在一项基于人群的 9 年随访设计中，我们评估了 2006-2008 年进行的特隆德拉格健康研究（HUNT3）中基于问卷的头痛诊断、偏头痛和紧张型头痛（TTH），并在 2015 年 12 月之前评估了随后发生 AF 的风险。风险人群由 39340 名≥20 岁、在 HUNT3 基线时无 AF、且在 HUNT3 期间回答过头痛问卷的个体组成。采用多变量 Cox 比例风险模型评估前瞻性关联，并计算 95%置信区间（CI）。

结果

在 39340 名参与者中，1524 名（3.8%）在 9 年随访期间发生 AF，其中 91%的患者年龄≥55 岁。在多变量分析中，调整已知混杂因素后，我们未发现偏头痛或 TTH 与 AF 风险之间存在任何关联。调整后的危险比（HR）分别为偏头痛 0.84（95%CI=0.64-1.11）、TTH 1.16（95%CI=0.86-1.27）和未分类头痛 1.04（95%CI=0.86-1.27）。然而，在≥55 岁患者的敏感性分析中，偏头痛患者发生 AF 的风险较低（HR=0.53；95%CI=0.39-0.73）。