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Headache and hypertension: refuting the myth

Department of Neurology, University Hospital, 750 E Adams Street, Syracuse, New York 13210, USA

Correspondence to:
Correspondence to:
Dr D Friedman;
friedmad@upstate.edu

Keywords: headache; hypertension; migraine

Patients often tell their physicians, "I know when my blood pressure is high because I get a headache". The relation of headache to hypertension has been debated in the medical literature for almost a century. Janeway observed it in a large clinical study of hypertensive patients (systolic blood pressure > 160 mm Hg) in 1913.¹ He described the "typical" hypertensive headache as non-migrainous, present upon awakening and resolving during the morning. However, his illustrative case histories are somewhat misleading because they all had malignant hypertension and systolic pressures > 230 mm Hg. Additionally, one patient was likely in analgesic rebound.

There are several reasons why the "hypertension headache" misperception persists: hypertension may be an epiphenomenon of acute pain, headache is associated with hypertensive encephalopathy as a manifestation of increased intracranial pressure, and headache is a side effect of some antihypertensive treatments. Conversely, many of the antihypertensive medications . . . [Full text of this article]

This article has been cited by other articles:

				M. Law, J. K. Morris, R. Jordan, and N. Wald Headaches and the Treatment of Blood Pressure: Results From a Meta-Analysis of 94 Randomized Placebo-Controlled Trials With 24 000 Participants Circulation, October 11, 2005; 112(15): 2301 - 2306. [Abstract] [Full Text] [PDF]