Open Access Open Badges Research article

Epidemiological profiles of patients with chronic migraine and chronic tension-type headache

Sara H Schramm1*, Mark Obermann2, Zaza Katsarava3, Hans-Christoph Diener2, Susanne Moebus1 and Min-Suk Yoon4

Author Affiliations

1 Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of University Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany

2 Department of Neurology, University Hospital of University Duisburg-Essen, Hufelandstr. 55, Essen, 45122, Germany

3 Department of Neurology, Evangelisches Krankenhaus Unna, Holbeinstraße 10, Unna, 59423, Germany

4 Department of Neurology, St. Joseph Hospital, Ruhr-University of Bochum, Gudrunstr. 56, Bochum, 44791, Germany

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The Journal of Headache and Pain 2013, 14:40  doi:10.1186/1129-2377-14-40

Published: 7 May 2013



We evaluated risk factors associated with chronic headache (CH) such as age, gender, smoking, frequent drinking of alcoholic beverages (drinking), obesity, education and frequent intake of acute pain drugs to test their usefulness in clinical differentiation between chronic migraine (CM) and chronic tension-type headache (CTTH).


We used baseline data from the population-based German Headache Consortium Study including 9,944 participants aged 18–65 years, screened 2003–2005, using validated questionnaires. CM and CTTH were defined according to IHS criteria. Multinominal logistic regression analyses were used to investigate the association of CM or CTTH with risk factors by estimating odds ratios (OR) and 95% confidence intervals (95%CI).


The prevalence of CH was 2.6% (N = 255, mean age 46 ± 14.1 years, 65.1% women), CM 1.1% (N = 108, 45 ± 12.9 years, 73.1%), CTTH 0.5% (N = 50, 49 ± 13.9 years, 48.0%). Participants with CM compared to CTTH were more likely to be female (OR: 2.34, 95%CI: 1.00-5.49) and less likely to drink alcohol (0.31, 0.09-1.04). By trend they seemed more likely to smoke (1.81, 0.76-4.34), to be obese (1.85, 0.54-6.27), to report frequent intake of acute pain drugs (1.68, 0.73-3.88) and less likely to be low educated (0.72, 0.27-1.97).


We concluded that the careful assessment of different risk factors might aid in the clinical differentiation between CM and CTTH.

Chronic migraine; Chronic tension-type headache; Epidemiology; Risk factors