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PO-27 Higher Central Augmentation Pressure/Index is Associated with Tension-Type Headache but Not Migraine in Middle-Aged/Older Obese Humans

Abstract

Objectives

Obesity is associated with a five-fold increased risk of developing chronic daily headache, especially chronic migraine. Migraine attacks are more frequent and more severe among obese migraineurs and they improve with weight loss; however, the underlying mechanisms are unknown. Given that elevated aortic stiffness and central pulse pressure are associated with cerebral microvascular dysfunction/damage, we hypothesized that obese middle-aged/older adults with history of migraine would demonstrate higher aortic stiffness, central blood pressure (BP) and augmentation index (AI) /pressure (AP) compared with those without a history of migraine.

Methods

Middle-aged/older obese adults who were stratified (via detailed survey and physical exam by a neurologist) by presence of migraine (n = 39; age 54 ± 8 yrs, BMI 38 ± 6 kg/m2, 67% female), tension-type headache (n = 25; age 57 ± 6 yrs, BMI 37 ± 4 kg/m2, 72% female) or no headache of any type (n = 29; age 54 ± 7 yrs, BMI 37± 5, 37± 5 kg/m2, 48% female) had aortic stiffness (carotid-femoral pulse wave velocity, CFPWV), brachial and central BP, and central AI and AP assessed by applanation tonometry (SphygmoCor).

Results

Obese adults with tension-type headache, but not migraine (P = 0.29), demonstrated higher AI (25.4 ± 9.6 vs. 17.8 ± 6.9%, P = 0.02) and AP (11.7 ± 9.6 vs. 6.8 ± 6.9 mmHg, P = 0.01) compared with no headache controls, but no difference in CFPWV between the 3 groups (P = 0.47). After adjusting for age, mean BP, female sex, weight, height, and antihypertensive medication, higher AP (β = 2.95, p = 0.04) and AI (β = 4.41, P = 0.07) remained associated with greater frequency of tension-type headache.

Conclusions

Higher central AI and AP, but not aortic stiffness, is associated with tension-type headache but not migraine in obese middle-aged/older adults. Whether excessive penetration of pulsatile pressure into cerebral microcirculation contributes to the development of tension-type or migraine headache in obesity requires further study.

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This is an open access article distributed under the CC BY-NC license http://creativecommons.org/licenses/by/4.0/.

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Kalil, G., Recober, A., Haynes, W.G. et al. PO-27 Higher Central Augmentation Pressure/Index is Associated with Tension-Type Headache but Not Migraine in Middle-Aged/Older Obese Humans. Artery Res 8, 175–176 (2014). https://doi.org/10.1016/j.artres.2014.09.033

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.033