Association Between Migraine and Hypertension in 2 Million Adolescents

BACKGROUND: 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. METHODS: 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. RESULTS: 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]). CONCLUSIONS: 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.