title: History of Migraine Predicts Headache at High Altitude.
abstract: Davis, Christopher, Elaine Reno, Edward Maa, and Robert Roach. History of Migraine Predicts Headache at High Altitude. High Alt Med Biol. 17:300-304, 2016.-Objective: To characterize the spectrum of headaches and their association with migraine history within a population of recreational hikers above 4300 m.
  
  
  METHODS
  Using a cross-sectional survey design, a convenience sample of 667 hikers participated in a written survey after descent from Mount Gray/Torreys (4349 m). Headaches were characterized as migraine, high altitude headache (HAH), and/or acute mountain sickness (AMS) using International Headache Society Lake Louise AMS scoring criteria. A univariate odds ratio was calculated to determine whether a history of migraine increased the risk of migrainous headache. Multivariate logistic regression was used to assess whether a priori identified risk factors such as age, sex, recent alcohol consumption, home elevation, and self-reported fluid intake and whether summit success increased the risk of any headache at altitude.
  
  
  RESULTS
  Sixty percent of hikers were male with an age range of 17-62 years. Eighty percent reached the summit of Mount Grays/Torreys (4349 m). Seventy-nine percent of participants resided in Colorado; the median elevation of residence for subjects was 1697 m (interquartile range 1557-1765 m). HAH occurred in 39% of hikers, while AMS occurred in 26% of hikers. A history of migraine was associated with increased risk of any headache at altitude (OR: 2.49, 95% CI: 1.62-3.65) and was strongly associated with the development of migrainous headache while at altitude (OR: 14.05, 95% CI: 5.49-35.93).
  
  
  CONCLUSIONS
  A history of migraine is a risk factor for the development of headache at altitude and is strongly associated with the development of migrainous headache.
authors: 1 Department of Emergency Medicine, Altitude Research Center, University of Colorado Denver , Anschutz Medical Campus, Aurora, Colorado.
authors: Christopher
authors: C
authors: Davis
authors: 1 Department of Emergency Medicine, Altitude Research Center, University of Colorado Denver , Anschutz Medical Campus, Aurora, Colorado.
authors: Elaine
authors: E
authors: Reno
authors: 2 Division of Neurology, Denver Health and Hospitals , Denver, Colorado.
authors: Edward
authors: E
authors: Maa
authors: 1 Department of Emergency Medicine, Altitude Research Center, University of Colorado Denver , Anschutz Medical Campus, Aurora, Colorado.
authors: Robert
authors: R
authors: Roach
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000531:Altitude; D000532:Altitude Sickness / Q000453:epidemiology / Q000209:etiology*; D003120:Colorado / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: acute mountain sickness; headache; high altitude; migraine