Cardiovascular Risk Factors in Cluster Headache

• Published in: Pain medicine (Malden, Mass.) Vol. 18; no. 6; pp. 1161 - 1167
• Main Authors: Lasaosa, S. Santos, Diago, E. Bellosta, Calzada, J. Navarro, Benito, A. Velázquez
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.06.2017
• Subjects: Adult; Ankle; Ankle Brachial Index - methods; Ankle Brachial Index - trends; Blood pressure; Blood Pressure Monitoring, Ambulatory - methods; Blood Pressure Monitoring, Ambulatory - trends; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - physiopathology; Carotid Intima-Media Thickness - trends; Cluster Headache - diagnosis; Cluster Headache - epidemiology; Cluster Headache - physiopathology; Cross-Sectional Studies; Female; Headache; Headaches; Humans; Male; Middle Aged; Risk Factors; Blood Pressure Dip; Cardiovascular Disease; Cluster Headache; Vascular Risk Factor; Ankle-Braquial Index; Intima-Media Thickness
• ISSN: 1526-2375; 1526-4637; 1526-4637
• DOI: 10.1093/pm/pnw305

Abstract Background. Patients with cluster headache tend to have a dysregulation of systemic blood pressure such as increased blood pressure variability and decreased nocturnal dipping. This pattern of nocturnal nondipping is associated with end-organ damage and increased risk of cardiovascular disease. Objective. To determine if cluster headache is associated with a higher risk of cardiovascular disease. Methods. Cross-sectional study of 33 cluster headache patients without evidence of cardiovascular disease and 30 age- and gender-matched healthy controls. Ambulatory blood pressure monitoring was performed in all subjects. We evaluate anthropometric, hematologic, and structural parameters (carotid intima-media thickness and ankle-brachial index). Results. Of the 33 cluster headache patients, 16 (48.5%) were nondippers, a higher percentage than expected. Most of the cluster headache patients (69.7%) also presented a pathological ankle-brachial index. In terms of the carotid intima-media thickness values, 58.3% of the patients were in the 75th percentile, 25% were in the 90th percentile, and 20% were in the 95th percentile. In the control group, only five of the 30 subjects (16.7%) had a nondipper pattern (P = 0.004), with 4.54% in the 90th and 95th percentiles (P = 0.012 and 0.015). Conclusions. Compared with healthy controls, patients with cluster headache presented a high incidence (48.5%) of nondipper pattern, pathological ankle-brachial index (69.7%), and intima-media thickness values above the 75th percentile. These findings support the hypothesis that patients with cluster headache present increased risk of cardiovascular disease.