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Caffeine as a risk factor for chronic daily headache

A population-based study

From the Department of Preventive Medicine and Biometrics (Dr. Scher), Uniformed Services University of the Health Sciences, Bethesda, MD, Outcomes Research Institute (Dr. Stewart), Geisinger Health Systems, Danville, PA, and Departments of Neurology, Epidemiology, and Population Health (Dr. Lipton), Albert Einstein College of Medicine, Bronx, NY.

Address correspondence and reprint requests to Dr. A.I. Scher, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814; e-mail: ascher{at}usuhs.mil

Objective: To investigate the possible association of dietary caffeine consumption and medicinal caffeine use with chronic daily headache (CDH).

Methods: Population-based cases and controls were recruited from the Baltimore, MD, Philadelphia, PA, and Atlanta, GA, metropolitan areas. Controls (n = 507) reported 2 to104 headache days/year, and cases (n = 206) reported 180 headache days/year. Current and past dietary caffeine consumption and medication use for headache were based on detailed self-report. High caffeine exposure was defined as being in the upper quartile of dietary consumption or using a caffeine-containing over-the-counter analgesic as the preferred headache treatment.

Results: In comparison with episodic headache controls, CDH cases were more likely overall to have been high caffeine consumers before onset of CDH (odds ratio [OR] = 1.50, p = 0.05). No association was found for current caffeine consumption (i.e., post CDH) (OR = 1.36, p = 0.12). In secondary analyses, associations were confined to younger (age <40) women (OR = 2.0, p = 0.02) and those with chronic episodic (as opposed to chronic continuous) headaches (OR = 1.69, p = 0.01), without physician consultation (OR = 1.67, p = 0.04) and of recent (<2 years) onset (OR = 1.67, p = 0.03).

Conclusion: Dietary and medicinal caffeine consumption appears to be a modest risk factor for chronic daily headache onset, regardless of headache type.

Received June 7, 2004. Accepted in final form August 10, 2004.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the December 14 issue to find the title link for this article.

This article has been cited by other articles:

				J. R. Couch, R. B. Lipton, W. F. Stewart, and A. I. Scher Head or neck injury increases the risk of chronic daily headache: A population-based study Neurology, September 11, 2007; 69(11): 1169 - 1177. [Abstract] [Full Text] [PDF]

				N. Gadoth, R. Hering-Hanit, A. I. Scher, W. F. Stewart, and R. B. Lipton Caffeine as a risk factor for chronic daily headache: A population-based study Neurology, July 12, 2005; 65(1): 180 - 180. [Full Text] [PDF]

				Is Caffeine Consumption a Risk Factor for Chronic Daily Headache? Journal Watch Neurology, April 7, 2005; 2005(407): 10 - 10. [Full Text]

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