Prevalence and risk factors of headaches in middle-aged and older Chinese adults with hypertension: a cross-sectional study based on CHARLS.

Headache among individuals with hypertension warrants considerable clinical attention, yet evidence regarding its prevalence and associated factors in this population remains limited. Using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), this cross-sectional study included 2,186 middle-aged and older adults with hypertension. Headache status was assessed through self-reported questionnaires, and potential associated factors were examined across five dimensions of the Health Ecology Model. Multivariable logistic regression analyses were performed to identify factors associated with headache. The prevalence of headache among hypertensive individuals was 32.0%. Female sex, self-assessed fair or poor health, shorter nighttime sleep duration, poor sleep quality, a history of falls, and the use of non-clean household fuels were associated with higher odds of reporting headache, whereas increasing age was inversely associated with headache. In addition, significant effect modification by residence location was observed for self-assessed health. These findings indicate that headache among middle-aged and older adults with hypertension is associated with a combination of physiological, behavioral, and environmental factors, highlighting the importance of targeted and context-specific strategies for headache prevention and management in this population.