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Potenziell vermeidbare Risikofaktoren für primäre Kopfschmerzen

Ein systematischer Review

Modifiable risk factors for primary headache

A systematic review

  • Leitthema
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Hintergrund

Vor dem Hintergrund des Risikos für eine Chronifizierung von Kopfschmerzen sind präventive Strategien von besonderer Bedeutung. Voraussetzung für die Prävention ist die Identifizierung von Risikofaktoren, die potenziell vermeidbar sind.

Ziel der Arbeit

Durch einen systematischen Review wird die Effektstärke putativ vermeidbarer Risikofaktoren wie Stress, Rauchen, Kaffeekonsum und Nacken- und Schulterschmerzen quantifiziert.

Material und Methoden

Eine systematische Literatursuche in den Datenbanken MEDLINE und Embase zu den Risikofaktoren wurde von 2 Personen unabhängig durchgeführt. Weitere Aufnahmekriterien waren: Beobachtungsstudien bei Erwachsenen in der Allgemeinbevölkerung bzw. Fall-Kontroll-Studien, bei denen der Effekt als OR berichtet ist oder sich aus gegebenen Daten berechnen lässt.

Ergebnisse

24 Studien konnten eingeschlossen werden. Bezüglich der Erfassung und Klassifizierung von Kopfschmerzen und Risikofaktoren sind die Studien sehr heterogen. Die Assoziation der Kopfschmerzen mit dem Risikofaktor Stress ist unabhängig vom Auslöser und der Kopfschmerzdefinition sehr hoch: Die Metaanalyse zeigt ein Gesamteffekt von 2,26 (OR mit 95 %-KI = [1,79; 2,85]). Die Studien zu Nacken- und Schulterschmerzen berichten ebenfalls über einen starken diesbezüglichen Zusammenhang, jedoch konnten die Ergebnisse nicht in einer Metaanalyse zusammengefasst werden. Auch die Ergebnisse für Rauchen und Kaffeekonsum als Risikofaktoren ließen sich nicht mit einem durchschnittlichen Effektschätzer belegen: Die Effekte waren eher gering und überwiegend nur bei höheren Dosen erkennbar.

Diskussion

Ein starker Zusammenhang zwischen Kopfschmerzen und den Risikofaktoren Stress und Nacken- und Schulterschmerzen wird bestätigt. Für Rauchen und Kaffeekonsum waren die Effekte eher gering.

Abstract

Background

Strategies to prevent primary headaches could be very beneficial, especially given that primary headaches can lead to the development of chronic headache. In order to establish headache prevention strategies, the modifiable risk factors for primary headaches need to be identified.

Material and methods

A systematic literature search on the risk factors for primary headaches was conducted independently by two persons using the databases MEDLINE and Embase. Further inclusion criteria were observational studies in adult general populations or case-control studies, where the effect sizes were reported as odds ratios or where the odds ratios could be calculated from the given data.

Results

In all, 24 studies were included in the analysis. There was a large amount of heterogeneity among the studies concerning headache acquisition, headache classification, and risk factors for headache development. Independent of headache trigger and definition of headache, the association between headache and the risk factor “stress” was very high: The meta-analysis shows an overall effect of 2.26 (odds ratio; 95 %-CI = [1.79; 2.85]). Studies evaluating neck and shoulder pain also report a strong association with headache; however, these results could not be summarized in a meta-analysis. Equally, the overall effects of smoking and coffee consumption on headaches could not be verified because the effect sizes were rather small and predominantly noticeable only at higher doses.

Conclusion

A strong association between headache and the risk factors stress and neck and shoulder pain was confirmed. The effect sizes of smoking and coffee consumption on headaches were rather small.

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Einhaltung ethischer Richtlinien

Interessenkonflikt

L. Albers, S. Ziebarth und R. von Kries geben an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Institut für soziale Pädiatrie und Jugendmedizin, Ludwig-Maximilians-Universität, Haydnstraße 5/VI Stock, 80336, München, Deutschland

    L. Albers, S. Ziebarth & R. von Kries

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  1. L. Albers
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  3. R. von Kries
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Correspondence to L. Albers.

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Albers, L., Ziebarth, S. & Kries, R. Potenziell vermeidbare Risikofaktoren für primäre Kopfschmerzen. Bundesgesundheitsbl. 57, 952–960 (2014). https://doi.org/10.1007/s00103-014-1997-1

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  • DOI: https://doi.org/10.1007/s00103-014-1997-1

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