A synergistic effect has been reported between female sex and high levels of daily stress, suggesting that sex-related factors and environmental stressors play a shared biological role in the development of migraine, according to the results of an analysis of data from the 2013 to 2014 Canadian Community Health Survey. Findings from the study were published in Neuroepidemiology.
The investigators sought to evaluate the prevalence of migraines among residents in Ontario, Canada, and the effect of sex and stress on migraines. A total of 42,282 individuals ≥12 years of age living in Ontario, Canada, with complete data available on both outcome and exposure were included in the analysis.
The prevalence of migraines was reported to be 10.7% among Ontario residents. Adjusted prevalence ratios were 2.37 (95% CI, 2.13-2.63) for women vs men, 1.63 (95% CI, 1.39-1.90) for individuals with high vs low levels of daily stress, and 3.38 (95% CI, 3.00-3.80) for women with high levels of daily stress vs men with low levels of daily stress.
The prevalence of migraine was 2 times as high among women compared with men (14.93% vs 6.33%, respectively; P <.0001). Further, the prevalence of migraines was higher among individuals with high levels of self-perceived daily stress compared with low levels of reported stress (16.60% vs 9.03%, respectively; P <.0001). Migraines were also reported significantly more often among those with mood disorders (24.08% vs 9.49%, respectively; P <.0001), those with a low annual household income (12.52%; P <.0001), and those 30 to 59 years of age (13.08%; P <.0001). Those with chronic diseases had a lower prevalence of migraine, most likely because of the higher proportion of individuals ≥60 years of age.
A major limitation of the study was the lack of data on pharmaceutical treatments for migraine among Ontario residents. Classification bias may also be a significant limitation in population studies of migraine prevalence because of difficulties involved in the diagnosis and characterization of migraine and other headache disorders. The cross-sectional design of this study does not offer information on the causal pathways that lead to migraine.
The investigators concluded that women who are exposed to daily stress have a higher prevalence of migraine headaches. Psychosocial or therapeutic interventions that target this high-risk population may thus prove beneficial.
Slatculescu AM, Chen Y. Synergism between female gender and high levels of daily stress associated with migraine headaches in Ontario, Canada. Neuroepidemiology. 2018;51(3-4):183-189.