HEADACHE IN
PATIENTS WITH MILD TO MODERATE HYPERTENSION IS GENERALLY NOT ASSOCIATED WITH
SIMULTANEOUS BLOOD PRESSURE ELEVATION.
Kruszewski P, et al. J Hypertens. 2000 Apr18(4):437-44.
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. > or = 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.