Headache and biomarkers predictive of vascular disease in a representative sample of US children.

OBJECTIVE To examine the association of childhood headache disorders with markers of risk for cardiovascular and cerebrovascular disease. DESIGN Information was collected on severe or recurrent headache or migraine in childhood or adolescence and on biomarkers predictive of vascular disease. SETTING The National Health and Nutrition Survey, a nationally representative health survey. PARTICIPANTS Children or adolescents aged 4 to 19 years (n = 11 770) who took part in the National Health and Nutrition Survey in 1999 through 2004. MAIN EXPOSURE Headache. MAIN OUTCOME MEASURES Body mass index; levels of C-reactive protein, homocysteine, serum and red blood cell folate, vitamin B(12), methylmalonic acid, total cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, triglycerides, and uric acid; and platelet count. RESULTS Mean values for body mass index, C-reactive protein, and homocysteine were higher in children with than without headaches, and more children with headaches were in the highest quintile of risk for these factors. Serum and red blood cell folate levels were lower in children with headache. More children with headache were in the highest quintile of risk for 3 or more of these factors. CONCLUSIONS Several important risk factors for long-term vascular morbidity cluster in children and adolescents with severe or recurrent headache or migraine. Further study and screening of children with headaches may permit improved preventive management.