Acupuncture Is Effective at Reducing the Risk of Stroke in Patients with Migraines: A Real-World, Large-Scale Cohort Study with 19-Years of Follow-Up

Chung-Chih Liao; Chi-Hsien Chien; Ying-Hsiu Shih; Fuu-Jen Tsai; Jung-Miao Li

doi:10.3390/ijerph20031690

Acupuncture Is Effective at Reducing the Risk of Stroke in Patients with Migraines: A Real-World, Large-Scale Cohort Study with 19-Years of Follow-Up

Int J Environ Res Public Health. 2023 Jan 17;20(3):1690. doi: 10.3390/ijerph20031690.

Authors

Chung-Chih Liao¹, Chi-Hsien Chien¹, Ying-Hsiu Shih^{2

3}, Fuu-Jen Tsai^{4

5

6

7}, Jung-Miao Li^{4

8}

Affiliations

¹ Department of Post-Baccalaureate Veterinary Medicine, Asia University, Taichung 41354, Taiwan.
² Management Office for Health Data, China Medical University Hospital, Taichung 40201, Taiwan.
³ College of Medicine, China Medical University, Taichung 40402, Taiwan.
⁴ School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
⁵ Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan.
⁶ Division of Medical Genetics, China Medical University Children's Hospital, Taichung 40447, Taiwan.
⁷ Department of Biotechnology and Bioinformatics, Asia University, Taichung 41354, Taiwan.
⁸ Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan.

Abstract

Migraines are common headache disorders and risk factors for subsequent strokes. Acupuncture has been widely used in the treatment of migraines; however, few studies have examined whether its use reduces the risk of strokes in migraineurs. This study explored the long-term effects of acupuncture treatment on stroke risk in migraineurs using national real-world data. We collected new migraine patients from the Taiwan National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2017. Using 1:1 propensity-score matching, we assigned patients to either an acupuncture or non-acupuncture cohort and followed up until the end of 2018. The incidence of stroke in the two cohorts was compared using the Cox proportional hazards regression analysis. Each cohort was composed of 1354 newly diagnosed migraineurs with similar baseline characteristics. Compared with the non-acupuncture cohort, the acupuncture cohort had a significantly reduced risk of stroke (adjusted hazard ratio, 0.4; 95% confidence interval, 0.35-0.46). The Kaplan-Meier model showed a significantly lower cumulative incidence of stroke in migraine patients who received acupuncture during the 19-year follow-up (log-rank test, p < 0.001). Acupuncture confers protective benefits on migraineurs by reducing the risk of stroke. Our results provide new insights for clinicians and public health experts.

Keywords: National Health Insurance Research Database; acupuncture; migraine; stroke.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Acupuncture Therapy* / adverse effects
Cohort Studies
Follow-Up Studies
Humans
Incidence
Migraine Disorders* / complications
Migraine Disorders* / epidemiology
Migraine Disorders* / therapy
Proportional Hazards Models
Retrospective Studies
Risk Factors
Stroke* / epidemiology
Stroke* / etiology
Stroke* / prevention & control
Taiwan / epidemiology

Grants and funding

This study is supported in part by the Ministry of Science and Technology (MOST 111-2321-B-039-005), China Medical University Hospital (DMR-111-105). No additional external funding was received for this study.