目的: 分析原发性头痛与原发性高血压发病风险之间的联系,为防治原发性高血压和原发性头痛提供依据。方法: 选取年龄为16～24岁(平均年龄18.6岁)的青年,通过体检数据,采用倾向性评分匹配的方法以均衡混杂因素,结合 logistic回归分析探讨匹配前后原发性头痛与原发性高血压发病风险之间的关系。结果: 匹配前高血压组和正常血压组在民族(P=0.007)、BMI(P=0.005)、高血压家族病史(P=0.017)、食用盐情况(P=0.004)、食肉种类(P=0.015)、是否饮食搭配(P=0.015)、睡眠质量(P=0.018)、每周体力活动量(P＜0.001)、久坐时间(P=0.023)、头痛类型(P＜0.001)等方面均有差异。进行 1∶1倾向性评分匹配后共获得246例匹配资料,并且两组间混杂因素达到均衡。logistic回归分析表明,匹配前偏头痛组发生高血压的风险是无头痛组的4.474倍,紧张型头痛组发生高血压的风险是无头痛组的1.942倍,其他头痛组与高血压无关。匹配后偏头痛组发生高血压的风险是无头痛组的 2.532倍,紧张型头痛组与其他头痛组与高血压无关。结论: 原发性头痛中的偏头痛对原发性高血压的发病风险存在影响作用,偏头痛是原发性高血压的独立危险因素。
Objective: To analyze the relationship between primary headache and the risk of primary hypertension, and to provide evidence for the prevention and treatment of primary hypertension and primary headache. Methods: The research subjects were selected from young people, ranging in age from 16 to 24 years old, with an average age of 18.6 years old. Through the physical examination data, the propensity score matching method was used to balance the confounding factors, and the logistic regression analysis was used to explore the relationship between primary headache and the risk of primary hypertension before and after matching. Results: There were differences between the hypertension group and the normal blood pressure group in nationality (P=0.007), BMI (P=0.005), family history of hypertension (P=0.017), salt consumption (P=0.004), meat type (P=0.015), diet matching (P=0.015), sleep quality (P=0.018), weekly physical activity (P＜0.001), sedentary time (P=0.023), headache type (P＜0.001), etc. A total of 246 matching data were obtained after matching with 1∶1 tendency score, and the confounding factors between the two groups reached a balance. Logistic regression analysis showed that the risk of hypertension in the migraine group before matching was 4.474 times higher than that in the non-headache group, and the risk of hypertension in the tension-type headache group was 1.942 times higher than that in the non-headache group. After matching, the risk of hypertension in the migraine group was 2.532 times higher than that in the non-headache group. The tension-type headache group and other headache groups were not related to hypertension. Conclusion: Migraine in primary headache have an impact on the risk of primary hypertension, and it is independent risk factors for primary hypertension.
[1] Mills KT, Stefanescu A, He J. The global epidemiology of hypertension[J].Nat Rev Nephrol, 2020,16(4):223-237.
[2] NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019:a pooled analysis of 1 201 population-representative studies with 104 million participants[J].Lancet, 2021,398(10304):957-980.
[3] Stovner LJ, Hagen K, Linde M, et al. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates[J].J Headache Pain, 2022,23(1):34.
[4] Yu SY, Liu RZ, Zhao G, et al. The prevalence and burden of primary headaches in China: a population-based door-to-door survey[J].Headache, 2012,52(4):582-591.
[5] Entonen AH, Suominen SB, Korkeila K, et al. Migraine predicts hypertension: a cohort study of the Finnish working-age population[J].Eur J Public Health, 2014,24(2):244-248.
[6] Rist PM, Winter AC, Buring JE, et al. Migraine and the risk of incident hypertension among women[J].Cephalalgia, 2018,38(12):1 817-1 824.
[7] Zhang J, Mao YK, Li YS, et al. Association between migraine or severe headache and hypertension among US adults: a cross-sectional study[J].Nutr Metab Cardiovasc Dis, 2023,33(2):350-358.
[8] Entonen AH, Suominen SB, Sillanmaki LH, et al. Prevalent migraine as a predictor of incident hypertension[J].Eur J Public Health, 2022,32(2):297-301.
[9] Wang YC, Lin CW, Ho YT, et al. Increased risk of ischemic heart disease in young patients with migraine: a population-based, propensity score-matched, longitudinal follow-up study[J].Int J Cardiol, 2014,172(1):213-216.
[10] Gardener H, Monteith T, Rundek T, et al. Hypertension and migraine in the northern Manhattan study[J].Ethn Dis, 2016,26(3):323-330.
[11] Mohammadi M, Ayoobi F, Khalili P, et al. Relation of hypertension with episodic primary headaches and chronic primary headaches in population of Rafsanjan cohort study[J].Sci Rep, 2021,11(1):2471.
[12] Manandhar K, Risal A, Koju R, et al. If headache has any association with hypertension, it is negative.Evidence from a population-based study in Nepal[J].Cephalalgia, 2021,41(13):1310-1317.
[13] Wang L, TanH P, Han R. The association between blood pressure and headache in postmenopausal women: aprospective hospital-based study[J].Int J Gen Med, 2021,14:2563-2568.
[14] Centeno Cordova MA, Stausberg D, Wang BY, et al. Headache is associated with low systolic blood pressure and psychosocial problems in German adolescents: results from the population-based German KiGGS study[J].J Clin Med, 2021,10(7):1492.
[15] He MW, Yu SY, Liu RZ, et al. Elevated blood pressure and headache disorders in China: associations, under-treatment and implications for public health[J].J Headache Pain, 2015,16(1):86-86.
[16] 郑文龙,范莉莉,张爽,等. 基于居民营养监测的高血压与全因死亡、心脑血管疾病死亡相关性的队列研究[J].中国慢性病预防与控制,2022,30(7):512-516.
[17] Yu SY, Cao XT, Zhao G, et al. The burden of headache in China: validation of diagnostic questionnaire for a population-based survey[J].J Headache Pain, 2011,12(2):141-146.
[18] 中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会等. 中国高血压防治指南(2018年修订版)[J].中国心血管杂志,2019,24(1):24-56.
[19] 中国营养学会肥胖防控分会,中国营养学会临床营养分会,中华预防医学会行为健康分会,等. 中国居民肥胖防治专家共识[J].西安交通大学学报(医学版),2022,43(4):619-631.
[20] Mckeough Z, Cheng SWM, Alison J, et al. Low leisure-based sitting time and being physically active were associated with reduced odds of death and diabetes in people with chronic obstructive pulmonary disease: a cohort study[J].J Physiother, 2018,64(2):114-120.
[21] 杨嘉馨,王文杰,王可馨,等. 睡眠质量与青年冠心病严重程度的相关性研究[J].临床心血管病杂志,2023,39(3):214-219.
[22] 张瑞霞,周跃辉. 吸烟大学生体力活动与烟草依赖相关分析[J].中国运动医学杂志,2021,40(1):55-60.
[23] Null.Headache classification committee of the international headache society (IHS) the international classification of headache disorders, 3rd edition[J].Cephalalgia, 2018,38(1):1-211.
[24] Seng EK, Gosnell I, Sutton L, et al. Behavioral management of episodic migraine: maintaining a healthy consistent lifestyle[J].Curr Pain Headache Rep, 2022,26(3):247-252.
[25] Valenzuela PL, Carrera BP, Gálvez BG, et al. Lifestyle interventions for the prevention and treatment of hypertension[J].Nat Rev Cardiol, 2020,18(4):251-275.
[26] Finocchi C, Sassos D. Headache and arterial hypertension[J].Neurol Sci, 2017,38(Suppl 1):67-72.
[27] Wu Y, Ding Y, Ramprasath T, et al. Oxidativestress, GTPCH1, and endothelial nitric oxide synthase uncoupling in hypertension[J].Antioxid Redox Signal, 2020,34(9):750-764.
[28] Sassi KLM, Martins LB, DeMiranda AS, et al. Renin-angiotensin-aldosterone system and migraine: asystematic review of human studies[J].Protein Pept Lett, 2020,27(6):512-519.
