Association Between Migraine and Hypertension in 2 Million Adolescents

An association between migraine and hypertension has long been suggested. However, previous studies yielded conflicting results, and only a few were conducted in adolescents. We aimed to investigate the association between migraine and hypertension in a large population-based study of adolescents.

We conducted a cross-sectional study of 2 155 077 adolescents (mean age 17.2±0.5 years) who underwent preenlistment screening for mandatory military service between 1990 and 2019. All recruits underwent hypertension screening, and those with suspected hypertension underwent a comprehensive evaluation to confirm the diagnosis. Migraine diagnoses were determined based on examinations by board-certified neurologists. Logistic regression models were used to estimate the odds ratios (OR) for hypertension among individuals with migraine, adjusting for potential confounders.

Among 61 314 adolescents diagnosed with migraine, 444 (0.7%) were diagnosed with hypertension, compared with 4570 (0.2%) among nonmigraineurs, yielding a multivariable adjusted OR of 3.01 (95% CI, 2.72-3.33). The association was stronger for severe migraine (OR, 4.41 [95% CI, 3.87-5.03]). Associations were stronger for a diagnosis of severe hypertension (adjusted OR, 3.34 [95% CI, 2.92-3.82]) than with mild hypertension (adjusted OR, 2.67 [95% CI, 2.30-3.10]).

Our study demonstrates a significant association between migraine and hypertension, which is more pronounced in cases of high-severity migraine. These findings suggest that adolescents with migraine may benefit from targeted hypertension screening to facilitate early detection and management.