Their study found that people who reported headaches had more stress compared to those who never reported headaches.
Increasing stress resulted in more headaches of all types, but that effect was particularly pronounced in people with tension headaches.
"Our findings are important to support the tailoring of stress management in patients with different types of headaches," said lead researcher Dr. Sara Schramm, at the University Hospital of University Duisburg-Essen.
"The benefit from interventions for stress might be slightly higher in patients with tension headaches than in migraine patients," she said.
The findings are scheduled to be presented at the annual meeting of the American Academy of Neurology, held from Apr. 26 to May 3 in Philadelphia. The results should be viewed as preliminary until published in a peer-reviewed journal.
The researchers collected data on more than 5,000 people aged 21 to 71. Four times a year for two years, the participants were quizzed about their levels of stress and headaches.
Each time, they were asked to rate their stress level on a scale of zero to 100 and recount how many headaches they had a month.
Schramm's team found that 31 percent of the participants had tension-type headaches, 14 percent had migraines, 11 percent had migraines combined with tension headaches and 17 percent had unclassified headaches.
People with tension headaches scored their stress level at an average of 52 of 100. For those with migraine, it was 62 of 100, and the stress level was 59 of 100 for those who suffered migraine and tension headaches.
Rising stress was clearly connected to a rise in the number of monthly headaches.
For those with tension headaches, a 10-point increase on the stress scale was associated with a 6.3 percent increase in the number of headaches, the researchers found. Among those who suffered migraines, the number rose 4.3 percent for a 10-point increase in stress, and for those with both headache types, it rose 4 percent.
To be sure stress was the culprit, Schramm's team ruled out other factors associated with headaches, including drinking, smoking and frequent use of drugs to treat headaches.
One expert not involved with the study said it confirms the widely held belief that chronic stress is a major trigger of all types of headaches in people young and old.
"Chronic intractable headache represents a major public health issue that is associated with impaired quality of life, as well as a significant economic and social burden," said Dr. Souhel Najjar, director of the Neuroscience Center at Staten Island University Hospital, in New York City.
"This finding is important and suggests that identifying sources of chronic stress, and utilizing strategies directed toward elimination or modification of stress, including meditation, deep breathing exercises and muscle relaxation techniques, can be very effective in reducing the frequency of all types of headaches, particularly tension headaches," Najjar said.
He said that such approaches could also reduce the toll headaches take on quality of life and their related costs.
To learn more about headaches, visit the U.S. National Library of Medicine.