Comorbidity profiles of chronic migraine sufferers in a national database in Taiwan

Yong-Chen Chen,Shuu-Jiun Wang,Kwong Ng,Chao-Hsiun Tang

doi:10.1007/s10194-012-0447-4

Abstract

Chronic migraine (CM; ≥15 headache days per month, ≥3 months) is associated with a higher prevalence of comorbidities than episodic migraine (<15 headache days per month). However, it is unclear whether a similar pattern exists in Asian patients. To examine this, a retrospective matched cohort study was conducted using the Taiwan National Health Insurance Research Database. CM cases were defined as patients with at least one neurological outpatient visit with a primary or secondary ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) code of 346.11, diagnosed by neurologists at medical centers during 2007–2008. The study group was compared with patients suffering from other migraine subtypes and non-migraineurs in the general population. Both comparison groups were matched with CM sufferers at a 4:1 ratio by age, gender, urbanization level of the residence, income, and hospital setting. Relative risk (RR) was calculated using conditional logistic regression. Compared with patients with other migraines (n = 2,226), CM sufferers (n = 681) had a higher risk of hyperlipidemia (RR = 1.32; P = 0.041), asthma (RR = 1.77; P = 0.007), depression (RR = 1.88; P < 0.0001), bipolar disorder (RR = 1.81; P = 0.022) and anxiety disorders (RR = 1.48; P = <0.0001). Compared with the non-migraineurs (n = 3,790), CM sufferers (n = 948) had significantly increased risks of cardiovascular disease, sinusitis, asthma, gastrointestinal ulcers, vertigo and psychiatric disorders by 1.6–3.9-fold. In conclusion, CM is associated with significant comorbidities in Asian patients. Differences in the comorbidity profiles of CM compared with other migraines have highlighted that patients with CM differ not just in terms of headache frequency but also in other important aspects.

Highlights

Migraine is a common neurological disorder affecting 9.1 % of the general population in Taiwan [1]
The present study found that patients with Chronic migraine (CM) had a significantly higher risk of hyperlipidemia (RR = 1.32), asthma (RR = 1.77), and anxiety disorders, depression and bipolar disorder (RR = 1.48–1.88) than those with other migraines
The Relative risk (RR) was significantly higher for sinusitis (RR = 1.77), asthma (RR = 2.27), and emphysema or chronic obstructive pulmonary disease (COPD) (RR = 1.73), and CM sufferers were found to Metabolic syndrome is a constellation of risk factors that contribute to the development of cardiovascular disease, cerebrovascular disease and diabetes mellitus

Summary

Introduction

Migraine is a common neurological disorder affecting 9.1 % of the general population in Taiwan [1]. It can be classified into two subgroups based on headache frequency, i.e. episodic migraine (EM; \15 headache days per month) and chronic migraine (CM, C15 headache days per months, C3 months) [2, 3]. It is estimated that EM sufferers develop CM at the rate of 2.5 % per year [4]. The prevalence rate of CM in Taiwan is estimated to be 1.7 %, with a female to male ratio of approximately 2:1 [5]. Previous studies have demonstrated that, when compared to EM, CM was associated with greater disability, poorer productivity, lower quality of life and higher healthcare expenditures [6,7,8,9]

Methods

Results

Discussion

Conclusion