Headaches and Blood Pressure

December 14, 2001

This research article shows that there is no association between the

occurrence of headache and variation of blood pressure, so that hypertensive

subjects should not rely on the presence or intensity of headaches to make

inferences about their blood pressure.

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Behavior of ambulatory blood pressure surrounding episodes of headache in

mildly hypertensive patients.

Gus M, Fuchs FD, Pimentel M, D, Melo AG, Moreira LB.

Arch Intern Med 2001 Jan 22; 161(2):252-5

BACKGROUND: Headache is usually associated with high blood pressure (BP)

despite the lack of evidence of such an association in most observational

studies. Ambulatory BP monitoring provides an opportunity to analyze this

relation because it permits measurement of BP before, during, and after

episodes of headache.

METHODS: We evaluated 76 patients with mild hypertension who underwent

clinical evaluation, ambulatory BP monitoring, and questioning about the

occurrence of headache and its characteristics during monitoring. The 24-hour

BP curves of patients with and without headache during monitoring were

compared using analysis of variance for multiple factors and repeated

measurements. Hourly averages of BP surrounding the episode and 24-hour mean

BP of patients with headache were compared using paired sample t tests.

RESULTS: Twenty-five participants (33%) experienced headache during

monitoring. Their 24-hour BP curves did not differ from those of participants

without headache. Mean 24-hour BP was not different from BP registered during

the episode of headache (mean ± SD systolic BP: 137.0 ± 17.3 vs 139.4 ± 21.1;

diastolic BP: 83.3 ± 12.8 vs 85.0 ± 18.2). Blood pressure values registered

during the episode of headache and in the hours before and after the episode

were not different from each other. Analysis restricted to 8 patients with

migrainelike headache showed a similar pattern.

CONCLUSIONS: In patients with mild hypertension, there is no association

between the occurrence of headache and variation of BP. Health professionals

must discourage patients with hypertension from believing that they can rely

on the presence of such a symptom to know about their BP levels.

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Dr Mel C Siff

Denver, USA

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