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Migraine associated with altitude : results from a population-based study in Nepal

Linde, M.; Edvinsson, L. LU ; Manandhar, K.; Risal, A. and Steiner, Timothy J. (2017) In European Journal of Neurology 24(8). p.1055-1061
Abstract

Background and purpose: A 1988 pilot study in Peru suggested an association between migraine and chronic exposure to high altitude. This study provides epidemiological evidence corroborating this. Methods: In a cross-sectional nationwide population-based study, a representative sample of Nepali-speaking adults were recruited through stratified multistage cluster sampling. They were visited at home by trained interviewers using a culturally adapted questionnaire. The altitude of dwelling of each participant was recorded. Results: Of 2100 participants, over half [1100 (52.4%)] were resident above 1000 m and almost one quarter [470 (22.4%)] at ≥2000 m. Age- and gender-standardized migraine prevalence increased from 27.9% to 45.5% with... (More)

Background and purpose: A 1988 pilot study in Peru suggested an association between migraine and chronic exposure to high altitude. This study provides epidemiological evidence corroborating this. Methods: In a cross-sectional nationwide population-based study, a representative sample of Nepali-speaking adults were recruited through stratified multistage cluster sampling. They were visited at home by trained interviewers using a culturally adapted questionnaire. The altitude of dwelling of each participant was recorded. Results: Of 2100 participants, over half [1100 (52.4%)] were resident above 1000 m and almost one quarter [470 (22.4%)] at ≥2000 m. Age- and gender-standardized migraine prevalence increased from 27.9% to 45.5% with altitude between 0 and 2499 m and thereafter decreased to 37.9% at ≥2500 m. The likelihood of having migraine was greater (odds ratio, 1.5–2.2; P ≤ 0.007) at all higher altitudes compared with <500 m. In addition, all symptom indices increased with altitude across the range <500 m to 2000–2499 m, i.e. median attack frequency from 1.3 to 3.0 days/month (P < 0.001), median duration from 9 to 24 h (P < 0.001) and pain intensity [the proportion reporting ‘bad pain’ (highest intensity)] from 35.5% to 56.9% (P = 0.011). Each of these showed a downward trend above 2500 m. Conclusions: Dwelling at high altitudes increases not only migraine prevalence but also the severity of its symptoms.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
altitude, epidemiology, Global Campaign against Headache, headache, hypoxia, migraine, prevalence, risk factors
in
European Journal of Neurology
volume
24
issue
8
pages
7 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85023614873
  • wos:000405551200011
ISSN
1351-5101
DOI
10.1111/ene.13334
language
English
LU publication?
yes
id
f7cb0712-9470-4247-b24f-304feca018be
date added to LUP
2017-08-01 11:40:40
date last changed
2017-09-18 11:40:38
@article{f7cb0712-9470-4247-b24f-304feca018be,
  abstract     = {<p>Background and purpose: A 1988 pilot study in Peru suggested an association between migraine and chronic exposure to high altitude. This study provides epidemiological evidence corroborating this. Methods: In a cross-sectional nationwide population-based study, a representative sample of Nepali-speaking adults were recruited through stratified multistage cluster sampling. They were visited at home by trained interviewers using a culturally adapted questionnaire. The altitude of dwelling of each participant was recorded. Results: Of 2100 participants, over half [1100 (52.4%)] were resident above 1000 m and almost one quarter [470 (22.4%)] at ≥2000 m. Age- and gender-standardized migraine prevalence increased from 27.9% to 45.5% with altitude between 0 and 2499 m and thereafter decreased to 37.9% at ≥2500 m. The likelihood of having migraine was greater (odds ratio, 1.5–2.2; P ≤ 0.007) at all higher altitudes compared with &lt;500 m. In addition, all symptom indices increased with altitude across the range &lt;500 m to 2000–2499 m, i.e. median attack frequency from 1.3 to 3.0 days/month (P &lt; 0.001), median duration from 9 to 24 h (P &lt; 0.001) and pain intensity [the proportion reporting ‘bad pain’ (highest intensity)] from 35.5% to 56.9% (P = 0.011). Each of these showed a downward trend above 2500 m. Conclusions: Dwelling at high altitudes increases not only migraine prevalence but also the severity of its symptoms.</p>},
  author       = {Linde, M. and Edvinsson, L. and Manandhar, K. and Risal, A. and Steiner, Timothy J.},
  issn         = {1351-5101},
  keyword      = {altitude,epidemiology,Global Campaign against Headache,headache,hypoxia,migraine,prevalence,risk factors},
  language     = {eng},
  month        = {08},
  number       = {8},
  pages        = {1055--1061},
  publisher    = {Wiley-Blackwell},
  series       = {European Journal of Neurology},
  title        = {Migraine associated with altitude : results from a population-based study in Nepal},
  url          = {http://dx.doi.org/10.1111/ene.13334},
  volume       = {24},
  year         = {2017},
}