About Hypertension Headaches

Overview

Hypertension headache refers to a type of headache that is associated with high blood pressure. Usually, hypertension does not cause headaches or other noticeable symptoms. A headache caused by hypertension may occur when blood pressure suddenly becomes very high (above 180/120). This is considered a hypertensive crisis and requires immediate medical attention. People who experience a sudden severe headache with high blood pressure should call 911 or be taken to the nearest emergency room. A hypertensive headache is often described as similar to a migraine, with throbbing pain that is worse with activity. Other symptoms of hypertension headache may include changes in vision, numbness, chest pain, and shortness of breath.

Frequent headaches in people with mild or moderate high blood pressure are generally not considered to be hypertension headaches. People who experience frequent or severe headaches should consult with their doctor for an accurate diagnosis and appropriate treatment.

Causes and Risk Factors

The exact causes of hypertension headache are not fully understood, but it is believed to be related to the following factors:

• Increased blood flow to the brain
• Activation of pain-sensitive structures in the blood vessels
• Disruption of normal brain function

The risk factor for hypertension headache is having hypertension. Risk factors for high blood pressure include:

• Family history of hypertension
• Age (being over 65 years old)
• Unhealthy diet
• Excessive dietary salt intake
• Inadequate dietary potassium intake
• Lack of physical activity
• Obesity
• High stress levels
• Excessive alcohol consumption
• Tobacco use

It's important to note that managing risk factors can help reduce blood pressure and the chances of developing hypertension headache. However, it's always best to consult with a healthcare professional for personalized advice on managing your risk factors.

Symptoms

In addition to a pulsating headache, symptoms of a hypertension headache may include:

• Dizziness
• Blurred vision
• A general feeling of being “off” or unwell
• Facial flushing
• Chest pain
• Nosebleeds
• Difficulty breathing
• Anxiety and confusion

More severe symptoms include:

• Confusion
• Vomiting
• Trouble with your balance, trouble feeling or moving one side of your body, drooping of one side of your face, trouble speaking

It's important to monitor your blood pressure regularly, as there are usually no warning signs or symptoms of hypertension. If any of the severe symptoms occur seek immediate medical attention or call 911.

Diagnosis

To diagnose hypertension headache, the following examinations, tests, and procedures may be performed:

• Physical exam: The healthcare provider will look for physical signs of a medical problem, and perform detailed eye and neurologic exams.
• Blood pressure measurement: This is a routine test to check for high blood pressure.
• Computed tomography (CT) scan: In an emergency setting, an urgent CT scan of the brain may be done if there are symptoms of acute headache and high blood pressure.
• Cardiac evaluation and echocardiogram: A cardiac evaluation may be recommended to check for cardiac causes of hypertension.

Additional examinations, tests, and procedures may include:

• Blood tests: Coagulation screening may be performed to assess blood clotting function.
• Magnetic resonance imaging (MRI) scans: If there are warning symptoms like partial responsiveness to medical therapy, visual disturbances, vomiting, or other signs of a stroke, an urgent MRI may be done.

Treatment Options

The goals of treatment for hypertension headache are to safely reduce blood pressure levels and reduce symptoms.

For hypertensive crisis causing the hypertensive headache, the immediate treatment is usually intravenous vasodilator medications to lower blood pressure by relaxing blood vessels. These medications are administered in an emergency room or hospital where blood pressure can be continuously checked.

After treating the hypertensive crisis and headache, the treatment goal is to keep blood pressure under control. Treatment may include:

Medications:

• Diuretics: These help reduce blood volume and pressure by promoting water and salt excretion through the kidneys.
• Calcium channel blockers and beta-blockers: These decrease heart rate and force, reducing blood flow and pressure.
• Angiotensin inhibitors and blockers: These medications inhibit the production of a hormone that narrows blood vessels, helping to lower blood pressure.

Therapies:

• Acupuncture: This traditional Chinese medicine intervention has been shown to reduce blood pressure with minimal side effects. It is noninvasive and can be combined with other treatments.
• Massage therapy and exercise can also be helpful as non-medication therapies for high blood pressure.

Health behavior changes:

• Adopting a healthy diet (such as the DASH diet)
• Regular exercise
• Weight management
• Stress reduction techniques
• Limiting alcohol consumption

Remember to consult your healthcare professional before making any changes or starting new treatments. Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Medication side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.