EPIDEMIOLOGY OF TENSION-TYPE HEADACHE

Context.-Tension-type headache is a highly prevalent condition, Becaus e few population-based studies have been performed, little is known ab out its epidemiology. Objectives.-To estimate the 1-year period preval ence of episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH) in a population-based study; to describe differences in 1-year period prevalence by sex, age, education, and race; and to d escribe attack frequency and headache pain intensity, Design.-Telephon e survey conducted 1993 to 1994. Setting.-Baltimore County, Maryland. Participants.-A total of 13 345 subjects from the community. Main Outc ome Measures.-Percentage of respondents with diagnoses of headache usi ng International Headache Society criteria. Workdays lost and reduced effectiveness at work, home, and school because of headache, based on self-report. Results.-The overall prevalence of ETTH in the past year was 38.3%, Women had a higher 1-year ETTH prevalence than men in all a ge, race, and education groups, with an overall prevalence ratio of 1. 16. Prevalence peaked in the 30- to 39-year-old age group in both men (42.3%) and women (46.9%). Whites had a higher 1-year prevalence than African Americans in men (40.1% vs. 22.8%) and women (46.8% vs 30.9%). Prevalence increased with increasing educational levels in both sexes , reaching a peak in subjects with graduate school educations of 48.5% for men and 48.9% for women. The 1-year period prevalence of CTTH was 2.2%; prevalence was higher in women and declined with increasing edu cation. Of subjects with ETTH, 8.3% reported lost workdays because of their headaches, while 43.6% reported decreased effectiveness at work, home, or school, Subjects with CTTH reported more lost workdays (mean of 27.4 days vs 8.9 days for those reporting lost workdays) and reduc ed-effectiveness days (mean of 20.4 vs 5.0 days for those reporting re duced effectiveness) compared with subjects with ETTH. Conclusions.-Ep isodic tension-type headache is a highly prevalent condition with a si gnificant functional impact at work, home, and school. Chronic tension -type headache is much less prevalent than ETTH; despite its greater i ndividual impact, CTTH has a smaller societal impact than ETTH.