Current Trends Prevalence of Chronic Migraine Headaches --- United States, 1980 - 1989

Migraine headaches, which are characterized by painful, disabling, and recurring symptoms, have no known cause, treatment, or cure. Quality population-based data are needed to improve epidemiologic understanding of chronic migraine headaches. This report uses data from the National Health Interview Survey (NHIS) to describe the prevalence of recent trends in the occurrence of chronic migraine headaches in the United States from 1980 through 1989.

Data for the NHIS were collected by CDC's National Center for Health Statistics (NCHS) through personal interviews with a representative sample of the civilian, (Continued on page 337) noninstitutionalized U.S. population. Information regarding chronic migraine headaches was obtained through a checklist of medical conditions (i.e., the respondent answered ``yes'' to the question, ``During the past 12 months, did anyone in the family have (a) migraine headache?'') or from reports of migraine headaches that restricted or limited activity or resulted in hospitalization. For the 10-year period, sample sizes ranged from approximately 60,000 to 125,000 persons. The data for 1980 are annual averages based on data from 1979 through 1981.

From 1980 through 1989, the prevalence of chronic migraine headaches in the United States increased nearly 60%, from 25.8 per 1000 persons (1) to 41.0 per 1000 persons (Table 1). Most (71%) of the increase occurred among persons less than 45 years of age. Because of sampling variability, differences between estimates based on single years of data may not be statistically significant, but comparisons between the 3-year averages for 1979--1981 (1) and 1986--1988 (NCHS, unpublished data) indicate a more than 40% increase in the prevalence of migraine headaches, from 25.8 to 36.7 per 1000 population.

In each year, the prevalence of migraine headaches was greater among women than men in each age group (Table 1). In addition, the rate of change was greater among women: from 1980 through 1989, the prevalence among women less than 45 years of age increased 77%, compared with a 64% increase among men.

The 3-year annual average of data from 1986 through 1988 showed that more than 80% of women and 70% of men reporting chronic migraine headaches had at least one physician contact per year because of migraine headaches; 8% and 7% of women and men, respectively, were hospitalized at least once a year because of the condition (NCHS, unpublished data). In addition, chronic migraine headaches had a substantial impact on functional capacity: 4% of men and 3% of women reported a chronic limitation in normal activity because of migraine headaches and associated symptoms.

In 1989, the prevalence of migraine headaches was highest in the western United States (45.4 per 1000 persons). In comparison, rates in the south and midwest were 41.0 and 40.4, respectively; rates were lowest in the northeast (36.9 per 1000). In addition, during 1986--1988, within each age group the prevalence of chronic migraine headaches was highest in the west and lowest in the northeast (Figure 1). Reported by: Illness Disability Statistics Br, Div of Health Interview Statistics, and National Ambulatory Medical Care Survey, Div of Health Care Statistics, National Center for Health Statistics, CDC.

Editorial Note

Editorial Note:

Chronic migraine headaches are classified either as ``common'' or ``classical.'' Manifestations of the common migraine headache include nausea, dizziness, fever, and general malaise. The classical migraine headache is most noted for an aura that immediately precedes the headache. In addition, the classical migraine headache is characterized by a relatively short duration (less than or equal to 12 hours) compared with the common migraine headache (up to 4 days) (2).

Although epidemiologic and clinical studies have not clearly defined the etiology of chronic migraine headaches, potential risk factors include diet, allergy, air quality, and stress (3,4). Reasons for the variations in prevalence of chronic migraine headaches by region are unclear but may reflect differences in the prevalence of risk factors, diagnostic practices, or the reporting behavior of NHIS respondents.

NHIS data on migraine headaches are collected on an ongoing basis using a standardized questionnaire and may be used as a source for surveillance of this problem. Both the increase of chronic migraine headache prevalence and the high level of medical care use and extensive disability (reflected by days of restricted activity) for this poorly understood condition suggest the need for further investigation of etiology and the need for improved treatment to ameliorate or reduce the disability.

References

1. Collins JG. Prevalence of selected chronic conditions, 1979--1981. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1986. (Vital and health statistics; series 10, no. 155).

2. Sacks O. Migraine---understanding a common disorder. Berkeley, California: University of California Press, 1985.

3. Linet MS, Stewart WF. Migraine headache: epidemiologic perspectives. Epidemiol Rev 1984;6:107--39.

4. Lai CW, Dean P, Zielger DK, Hassanein RS. Clinical and electrophysiological responses to dietary challenge in migraineurs. Headache 1989;29:180--6.

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