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KMID : 0911820210220020049
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Korean Journal of Headache
2021 Volume.22 No. 2 p.49 ~ p.55
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Comorbid Medical Conditions in Patients with Medication Overuse Headache: Multicenter Prospective Medication Overuse Headache Registry Analysis
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Hong Yoo-Ha
Cho Soo-Jin
Chu Min-Kyung
Oh Sun-Young
Moon Heui-Soo
Song Tae-Jin
Lee Mi-Ji
Kang Jin-Ju
Park Hong-Kyun
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Abstract
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Background: Medication overuse headache (MOH) is a severe disabling headache disorder related to medication overuse due to primary headache disorders. The prevalence of medical conditions that might influence MOH management has not been elucidated. We evaluated the frequencies of medical comorbidities and association between the burden of cardiovascular risk factors and use of preventive treatment in the patients with MOH.
Methods: Using a prospective multicenter MOH registry, we collected the history of comorbidities by the patient self-report. The patients reported the history and onset of hypertension, heart disease, diabetes, hyperlipidemia, liver disease, kidney disease, gastric ulcer/gastroesophageal reflux disease (GERD), fibromyalgia, cervical and lumbar radiculopathy, and depression. Also, history of the obesity and current smoking were collected.
Results: A total of 229 patients were enrolled. The most common medical comorbidity was cervical or lumbar radiculopathy (20.5%), followed by depression (20.1%), hypertension (19.2%), hyperlipidemia (18.8%), fibromyalgia (12.6%), diabetes (6.1%), and heart disease (2.2%). Gastric ulcer/GERD, kidney disease, and liver disease were reported in 19 (8.3%), 5 (2.2%), and 1 (0.4%) patients. The patients with a higher burden of cardiovascular risk factors were more likely to be older. In addition, the higher burden of cardiovascular risk factors, the more common antihypertensive drugs acting on renin-angiotensin system, botulinum toxin A, and occipital nerve block were used when choosing preventive treatment.
Conclusion: The patients with MOH had a significant proportion of medical comorbidities, especially cardiovascular risk factors. For the preventive treatment, physicians might consider the medical comorbidities including the burden of cardiovascular risk factors.
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KEYWORD
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Medication overuse headache, Comorbidity, Cardiovascular disease, Risk factor
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