Tension-type headache (TTH) is the most prevalent form of primary headache in the general population and the most prevalent neurologic disorder worldwide.[2]Jensen RH. Tension-type headache - the normal and most prevalent headache. Headache. 2018 Feb;58(2):339-45.
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Most patients with TTH have the infrequent episodic subtype, with headaches less than one day a month.[3]Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24.
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Data from the Global Burden of Disease (GBD) study estimate that there were 882.4 million new cases of TTH globally in 2017 and TTH was ranked as the second most common cause of chronic disease and injury worldwide.[3]Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24.
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In adults, the mean global prevalence of TTH has been reported as 42%.[4]Stovner Lj, Hagen K, Jensen R, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007 Mar;27(3):193-210.
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Prevalence estimates vary between studies and regions, however. This is, in part, due to differences in case definitions and study methods, as well as differences in ethnicity and other demographic characteristics of populations. In a population-based Danish twin registry, the self-reported one-year prevalence of TTH among 12- to 41-year-old subjects was 86%.[5]Russell MB, Levi N, Saltyte-Benth J, et al. Tension-type headache in adolescents and adults: a population based study of 33,764 twins. Eur J Epidemiol. 2006;21(2):153-60.
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The estimated one-year prevalence data from other populations vary widely: 10.8% in China; 36.1% in Jordan; 38.3% in the US; and 80% in Europe.[3]Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24.
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Data from the GBD study estimate that in 2017 there were 2.33 billion people with TTH worldwide, with 121.6 million in the US. Prevalence increased by 31.7% in the US from 1990 to 2017.[3]Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24.
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Chronic TTH has a prevalence of 2% to 3% in most studies.[3]Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24.
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The onset of TTH is generally between 20 and 30 years of age, with prevalence peaking between the ages of 20 to 39 years and then declining.[3]Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24.
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[6]Bendtsen L, Evers S, Linde M, et al. EFNS guideline on the treatment of tension-type headache - report of an EFNS task force. Eur J Neurol. 2010 Nov;17(11):1318-25.
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TTH has a slight female preponderance, with a female to male ratio of 1.2:1, much lower than the 3:1 ratio for migraine.[3]Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24.
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