July 1, 1998 More than four percent of the U.S. population suffers from "frequent headaches," defined as headaches that occur at least 180 days a year, according to researchers at the Johns Hopkins School of Public Health and presented June 26 at the 40th annual scientific meeting of the American Association for the Study of Headache (AASH), San Francisco. This survey also found that frequent headaches were nearly twice as common among women as men. Caucasians had headaches more often than African Americans, and those with less than a high-school education suffered from headaches more than those with higher levels of education.
Lead author Ann I. Scher, MS, a doctoral student in the Department of Epidemiology at the Johns Hopkins School of Public Health, said, "Although frequent or daily headache is surprisingly common, relatively little is known about the scope and distribution of the public health problem posed by this type of headache."
The survey involved 13,343 demographically diverse individuals aged 18 to 65 years who were selected by computerized random-digit dialing and interviewed about the symptoms, duration, and occurrence of their headaches. All those who reported having 180 or more non-migraine headaches per year were classified as having "frequent headache" and were interviewed at length.
Ms. Scher and principal investigator Walter Stewart, PhD, MPH, Department of Epidemiology, Johns Hopkins School of Public Health, subdivided frequent headaches into three types: frequent headache with migrainous features (FH/M), chronic tension-type headache (CTTH), and unclassified frequent headache (FH/O).
The data revealed that 4.1 percent of the population (5 percent of women and 2.8 percent of men) suffered from frequent headache. Frequent headache was 33 percent more common among Caucasians (4.4 percent) than African Americans (3.3 percent); and, among both genders, frequent headaches were most common among those with less than a high school education.
The most common form of frequent headache in the study was chronic tension-type headache (CTTH), prevalent in 2.2 percent of the participants and accounting for 53 percent of the frequent headaches suffered.
In contrast to migraine, in which the prevalence generally peaks in the 40s and declines thereafter, the prevalence of frequent headache did not show any clear associations with age.
Approximately seven million adults in the United States suffer from headaches at least every other day, accounting for millions of work days missed or reduced efficiency while at work. Studies in clinics have identified potential risk factors for frequent headaches, including overuse of painkillers, depression, insomnia, or stressful or traumatic life events. In clinics, most of those with frequent headache have what is called "transformed migraine headaches," often associated with analgesic overuse. These potential risk factors for frequent headaches, however, have not been tested in population-based samples and may not be associated with frequent headache in the general population.
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