Merikangas K R, Fenton B T, Cheng S H, Stolar M J, Risch N
Genetic Epidemiology Research Unit, Yale University School of Medicine, New Haven, Conn, USA.
Arch Neurol. 1997 Apr;54(4):362-8. doi: 10.1001/archneur.1997.00550160012009.
To examine the association between stroke and migraine in an epidemiological study. DATA SOURCES AND DESIGN: The National Health and Nutrition Examination Survey baseline and first follow-up data were used to investigate cross-sectional and longitudinal associations between headache/migraine and stroke.
Study participants from a national probability sample of the civilian noninstitutionalized population of the United States.
Self-reported physician diagnosis of stroke.
After controlling for established risk factors for stroke (hypertension, diabetes, heart disease, and gender), both migraine and severe nonspecific headache were associated with a significantly increased risk for stroke reported at follow-up. The risk for stroke associated with migraine decreased as the age at stroke increased.
Our results strengthen previous evidence regarding a nonrandom association of both headache and migraine with stroke, particularly among young women. To our knowledge, this is the first systematic examination in a large-scale prospective epidemiological study of men and women with sufficient statistical power to test the association between migraine and stroke in women. Severe headache and migraine should be considered as risk factors for the development of stroke, particularly in the absence of other well-established stroke risk factors. Further investigation is required to identify the putative mechanisms underlying comorbidity of migraine and stroke.
在一项流行病学研究中检验中风与偏头痛之间的关联。
利用国家健康与营养检查调查的基线数据和首次随访数据，研究头痛/偏头痛与中风之间的横断面关联和纵向关联。
研究参与者来自美国非机构化平民人口的全国概率样本。
自我报告的医生诊断的中风情况。
在控制了中风的既定风险因素（高血压、糖尿病、心脏病和性别）后，偏头痛和严重的非特异性头痛均与随访时报告的中风风险显著增加相关。与偏头痛相关的中风风险随着中风年龄的增加而降低。
我们的结果强化了先前关于头痛和偏头痛与中风存在非随机关联的证据，尤其是在年轻女性中。据我们所知，这是在一项大规模前瞻性流行病学研究中对有足够统计效力来检验女性偏头痛与中风关联的男性和女性进行的首次系统检查。严重头痛和偏头痛应被视为中风发生的风险因素，尤其是在没有其他既定中风风险因素的情况下。需要进一步研究以确定偏头痛和中风共病的潜在机制。
