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No Link Seen Between Hypertension And Headache
Journal of Neurology, Neurosurgery, & Psychiatry (JNNP Online)
03/25/2002
By Harvey McConnell
Headaches and hypertension appear to be linked - but the opposite to popular perceptions.
Severe headaches may not be a sign of hypertension, and if anything, hypertension may reduce the risk of such headaches, finds Dr Knut Hagen and colleagues at the Department of Clinical Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
There findings are based on a study of 22,685 adults who were not likely to have headache, had a baseline blood pressure measured in 1984-6, and who responded to a headache questionnaire at follow up 11 years later.
There is consensus among members of the International Headache Society that chronic arterial hypertension of mild to moderate degree does not cause headache, the clinicians point out. Most cross-sectional studies performed in unselected populations have shown no negative or positive association between blood pressure and the prevalence of headache.
At the same time, some studies have found a higher prevalence of headache and migraine has been reported in hypertensive patients than among normotensive controls. Other studies have found a higher prevalence of hypertension among patients who have headaches or migraine than among headache free people.
The researchers found that 28 percent of the cohort experienced repeated headaches, and one in four had migraine headaches. High systolic readings - above 150/90 mg Hg - tended to be associated with a 30 percent lower frequency of headache across all age groups.
Men and women with hypertension had fewer headaches than people with readings below 140 mg Hg: higher the systolic reading the lower the risk of headache.
When the researchers analysed headache by type, they found that high systolic pressure was associated with a lowered risk of non-migraine headache, and a lowered risk of migraine in women. The same was true of diastolic pressure, although there was no clear-cut association with migraine risk.
Dr Hagen and colleague conclude: "A possible explanation for this surprising result may be hypertension associated hypalgesia, which may involve the baroreflex system influencing nociception in the brain stem or spinal cord."
Journal of Neurology, Neurosurgery And Psychiatry 2002; 72: 463-6.
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