Factors associated with chronic headache among adults: results from a Ravansar noncommunicable disease cohort study

Background: Headache is the most common disorder of the central nervous system, and one of the most prevalent noncommunicable diseases. Aims: We aimed to determine factors associated with chronic headache among adults in the Islamic Republic of Iran. Methods: This was a cross-sectional study that recruited 10 063 participants from the baseline data of the Ravansar noncommunicable disease cohort study in western Islamic Republic of Iran in 2021. Participants who had headaches for >= 15 days per month for >= 3 months were considered as having chronic headache. Logistic regression was used to examine the associations. Results: The prevalence of chronic headache was 10.49% (n = 1054), and was significantly higher among females (14.55%, n = 769) than males (5.98%, n = 285) (P < 0.001). The risk of chronic headache among married females was 73% higher than among single females. Among male smokers, the risk of chronic headache was 1.47 times higher than among non-smokers [95% confidence interval (CI): 1.05, 2.06]. The risk of chronic headache among depressed males was 2.59 times higher than among non-depressed males (95% CI: 1.28, 5.22); and among depressed females the risk was 2.38 times higher than among non-depressed females (95% CI: 1.76, 3.23). Among males who lived in rural areas, the risk of chronic headache was 84% lower than among those who lived in urban areas; and among females who lived in rural areas it was 81% lower than those who lived in urban areas. Being menopausal and having normal sleep were significantly associated with lower risk, while comorbidity was associated with higher risk, of developing chronic headache. Conclusions: Depression, urban residence, smoking, comorbidity, and being married were associated with an increase in the risk of developing chronic headache, while higher education level, menopause and normal sleep were associated with a decrease in the risk of developing chronic headache.