Headache disorders continue to be among the most prevalent and burdensome conditions worldwide, affecting 2.9 billion people worldwide, ie, nearly 1 in every 3 people, and ranking sixth among all causes of health loss in 2023, a new analysis showed.

Women experienced more than twice the headache-related health loss of men, and migraine caused nearly 90% of all disability linked to headache disorders, even though tension-type headache was more common, the study showed.

And more than one fifth of the global headache burden was linked to pain medication overuse, suggesting that a “large part of the global headache burden is preventable,” lead author Andreas Kattem Husøy, with the Norwegian University of Science and Technology, Trodheim, Norway, said in a news release. 

The findings, from the Global Burden of Disease 2023 study, were published online on November 12 in Lancet Neurology.

Women Disproportionately Affected

For the analysis, researchers drew on global population-based studies to examine health loss resulting from headache disorders in 2023. Health loss was measured in years lived with disability (YLDs), which captures the total time people spend living with health conditions that limit daily activities and overall well-being.

They estimated that headache disorders accounted for an age-standardized rate of 541.9 YLDs per 100,000 people, representing a major cause of lost health and productivity.

There has been no meaningful change in headache burden over the last 30 years, suggesting that root causes remain unaddressed, the authors said.

They found marked sex differences in the burden of headache disorders.

The age-standardized YLD rate was more than twice as high among women as men, with rates of 739.9 and 346.1 YLDs per 100,000, respectively. Across all age groups, women consistently spent more time experiencing headache symptoms than men.

“Recognizing this is essential for improving how we prevent and manage headache disorders worldwide,” coauthor Yvonne Xu, of the Institute for Health Metrics and Evaluation at University of Washington, Seattle, said in the release.

Key Drivers

Although tension-type headache was nearly twice as common as migraine, migraine accounted for about 90% of all disability linked to headache disorders, a reflection of the more severe symptoms associated with episodes of migraine than tension-type headache, the authors noted.

In 2023, migraine caused an estimated 40.9 million YLDs worldwide, at a rate of 487.5 per 100,000 people, while tension-type headache accounted for 54.4 YLDs per 100,000.

The highest rates of migraine-related disability occurred in North Africa and the Middle East, closely followed by high-income regions including Europe and North America. 

Medication-overuse headache, defined as worsening of an existing headache due to excessive use of medication, was responsible for more than one fifth of global headache-related disability — a finding that has “profound clinical relevance, and implication for public health,” the authors wrote.

“This underpins the need to raise awareness, among both people with headache and healthcare providers, about the risks associated with the overuse of acute medication,” they said.

“Much headache-attributed burden could be averted or eliminated by avoiding overuse of medication (including over-the-counter medication), underscoring the importance of public education,” they concluded.

The study was funded by the Gates Foundation. A complete list of author disclosures is available with the original article.