ORIGINAL ARTICLE
Migraine associated with altitude: results from a population-based study in Nepal M. Lindea,b
Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim; bNorwegian Advisory Unit on Headache, St Olavs University Hospital, Trondheim, Norway; cInstitute of Clinical Sciences, Lund University, Lund, Sweden; dDhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal; and eDivision of Brain Sciences, Imperial College London, London, UK
Keywords:
altitude, epidemiology, Global Campaign against Headache, headache, hypoxia, migraine, prevalence, risk factors Received 18 February 2017 Accepted 1 May 2017 European Journal of Neurology 2017, 24: 1055–1061
doi:10.1111/ene.13334
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 genderstandardized 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
Migraine associated with altitude: results from a population-based study in Nepal M. Lindea,b
Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim; bNorwegian Advisory Unit on Headache, St Olavs University Hospital, Trondheim, Norway; cInstitute of Clinical Sciences, Lund University, Lund, Sweden; dDhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal; and eDivision of Brain Sciences, Imperial College London, London, UK
Keywords:
altitude, epidemiology, Global Campaign against Headache, headache, hypoxia, migraine, prevalence, risk factors Received 18 February 2017 Accepted 1 May 2017 European Journal of Neurology 2017, 24: 1055–1061
doi:10.1111/ene.13334
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 genderstandardized 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
