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

Objective Although headache is regarded a symptom of hypertension, its rela tion to blood pressure, especially in mild and moderate hypertension, is no t clear. Thus, the aim of the study was to investigate whether headache in patients with mild to moderate hypertension may be attributed to simultaneo us elevations in blood pressure. Design and methods Ambulatory blood pressure monitoring (ABPM) was performe d in patients (mean age 48 +/- 10 years, n = 150, 92 men, 58 women) classif ied, 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 pressur e elevations in the studied group of stage 1-2 hypertensive patients becaus e (i) blood pressure values from headache periods were not significantly hi gher than those from headache-free periods; (ii) blood pressure Values dire ctly preceding the pain were not significantly different from values at the beginning of headache; and (iii) in the vast majority of hypertensives, th eir maximal blood pressure values were recorded during headache-free period s. Moreover, in some instances, patients who showed maximal ABPM values dur ing headache had relatively high blood pressure, i.e. greater than or equal to 180/110 mmHg. Conclusions Our results did not support the opinion that headache experienc ed by stage 1-2 hypertensives was generally caused by simultaneous elevatio n in blood pressure. The direct mechanisms of headache in hypertension, as well as the relation between increments in blood pressure above 180/110 mmH g and headache, need further investigations. J Hypertens 2000, 18:437-444 ( C) Lippincott Williams & Wilkins.