Higher peak expiratory flow associated with decreased headache risk in middle-aged and older adults

1. Higher peak expiratory flow was associated with a lower probability and lower risk of headache in middle-aged and older adults. 

Evidence Rating Level: 2 (Good)

Headache is a common symptom of patients with chronic lung disease (CLD). Peak expiratory flow (PEF) is the maximum instantaneous flow rate during forced expiration in a forced vital capacity maneuver and serves as an important measure of lung function. The relationship between lung function and headache risk is unclear. This study thus investigated the association between lung function and headache risk through cross-sectional and longitudinal analyses. This study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2015 to 2020, comprising community-dwelling residents > 45 years across 28 provinces in China. The longitudinal component included participants with no history of headache diagnosis in the 2015 cross-sectional survey, who were followed up until 2020. The ratio of actual PEF values to predicted values (PEF% predicted) was used and split into quartiles: Q1 (< 66.0%), Q2 (66.0%–84.1%), Q3 (84.2%–101.5%), and Q4 (≥ 101.6%). In total, 10,917 participants (51.4 % aged >60 years, 43.9% male) were included in the cross-sectional analysis, with 1648 in the headache group and 9269 in the non-headache group.  Higher PEF% predicted was associated with a lower probability of headache (P < 0.05). Compared with the Q1 group, participants in the Q4 group had a lower probability of experiencing headaches (adjusted odds ratio (aOR) = 0.81, 95% CI 0.68–0.96). The longitudinal analysis included 2,428 (46.7%) participants newly diagnosed with headaches by the end of the follow-up period. Higher PEF% predicted was associated with a lower risk of headache (p < 0.05). Compared with the Q1 group, the Q4 group had a lower risk of headache (adjusted hazard ratio (aHR) = 0.80, 95% CI 0.72–0.91). Overall, this study found that a higher PEF% predicted was a protective factor for the occurrence of headache among a middle-aged and elderly population in China. Improving levels of PEF may be important in preventing headaches. Future studies are needed to validate these findings using other indicators of lung function.

Click to read the study in EJMR

Image: PD

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