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Headache in patients with mild to moderate hypertension is generally not associated with simultaneous blood pressure elevation

Kruszewski, Piotr1,2; Bieniaszewski, Leszek1; Neubauer, Jolanta1; Krupa-Wojciechowska, Barbara1

Original article

Objective Although headache is regarded a symptom of hypertension, its relation to blood pressure, especially in mild and moderate hypertension, is not clear. Thus, the aim of the study was to investigate whether headache in patients with mild to moderate hypertension may be attributed to simultaneous elevations in blood pressure.

Design and methods Ambulatory blood pressure monitoring (ABPM) was performed in patients (mean age 48 ± 10 years, n = 150, 92 men, 58 women) classified, according to their office blood pressure, as stage 1–2 hypertensives (JNC VI). Headache periods were recorded in patients' diaries.

Results Headaches were generally not directly associated with blood pressure elevations in the studied group of stage 1–2 hypertensive patients because (i) blood pressure values from headache periods were not significantly higher than those from headache-free periods; (ii) blood pressure values directly preceding the pain were not significantly different from values at the beginning of headache; and (iii) in the vast majority of hypertensives, their maximal blood pressure values were recorded during headache-free periods. Moreover, in some instances, patients who showed maximal ABPM values during headache had relatively high blood pressure, i.e. ≥ 180/110 mmHg.

Conclusions Our results did not support the opinion that headache experienced by stage 1–2 hypertensives was generally caused by simultaneous elevation in blood pressure. The direct mechanisms of headache in hypertension, as well as the relation between increments in blood pressure above 180/110 mmHg and headache, need further investigations.

Department of Hypertension and Diabetology. Medical University of Gdansk, Poland.

2Correspondence and requests for reprints to Piotr Kruszewski MD PhD, Department of Hypertension and Diabetology, Medical University of Gdansk, Debinki 7, 80–211 Gdansk, Poland

Fax: +48 58 349 23 41; e-mail:

Received 8 July 1999 Revised 8 December 1999 Accepted 4 January 2000

© 2000 Lippincott Williams & Wilkins, Inc.