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Mild Hypertension Not a Cause of Headaches

Study finds less pain among people with high blood pressure

MONDAY, March 25, 2002 (HealthDayNews) -- Contrary to what some might believe, adults with high blood pressure aren't any more likely to suffer headaches than those without the condition. Actually, they may be less likely to have headaches.

A Norwegian study of 22,685 people found that men and women whose systolic pressure -- the top of the two figures -- was above 150 at an initial reading were about 30 percent less likely to report having non-migraine headaches 11 years later as those whose pressure was below 140. A systolic pressure of 150 is considered to be mild to moderate hypertension.

The reason for the reduced risk isn't clear. But one possibility, which has evidence from both animals and people, is that as blood pressure rises, sensitivity to painful stimuli tends to drop.

"When you have high blood pressure, you don't feel so much pain. That may be an explanation to our findings," said Dr. Lars Stovner, a neurologist at the Norwegian University of Science and Technology in Trondheim and a co-author of the study. "We cannot be sure about this." A report on the findings appears in the current issue of the Journal of Neurology, Neurosurgery, and Psychiatry.

Stovner and his colleagues found that modestly elevated systolic and diastolic pressure were inversely linked to non-migraine headaches -- such as "tension" pain -- in both men and women, and even in people taking medication for their hypertension. They could not find a similar trend for migraine headaches.

"If you had low blood pressure 11 years before, there was a trend for more headaches 11 years after," Stovner said. The study didn't address extremely elevated blood pressure, which does cause headaches, he added.

Dr. Seymour Diamond, executive chairman of the National Headache Foundation, called the finding "an interesting statistic" with no practical implications for patients.

Blood pressure experts cautioned that the results are definitely not news you should use -- at least, not in the conventional way. Hypertension is a killer, causing heart attacks, strokes, kidney disease, and other complications. People should therefore not ignore treating it simply to avoid something as benign as a headache, said Dr. Ronald Smith, director of clinical research at the Hypertension and Vascular Disease Center at Wake Forest University Baptist Medical Center in Winston-Salem, N.C.

On the other hand, Smith said, hypertension is called the "silent killer" because it often has no symptoms. So people who might think the absence of tension headaches is a sign of healthy blood pressure shouldn't be so complacent.

"Common myth is that I get headaches when my blood pressure is high," Smith said. "Those of us in the field are aware clinically that was a wrong assumption. The Norwegian study prospectively proves that higher blood pressure is not associated with headache."

In fact, high blood pressure often results from headaches, said Dr. Lawrence Resnick, of Cornell University's Weill Medical College in Manhattan. "Whatever's causing the headache is causing the blood pressure to go up, not the other way around."

As a result, Resnick added, it's a mistake in almost every case for doctors to adjust blood pressure medication when a patient complains about headaches.

What To Do

High blood pressure affects about 25 percent of adults. For more on the condition, try the National Heart, Lung, and Blood Institute or the Arnot Ogden Medical Center.

For more on headaches, try the National Headache Foundation.

SOURCES: Lars Stovner, M.D., Ph.D., professor of neurology, Norwegian University of Science and Technology, Trondheim; Seymour Diamond, M.D., executive chairman, National Headache Foundation, Diamond Headache Clinic, Chicago; Lawrence Resnick, M.D., professor of medicine, Weill Medical College, Cornell University, New York; Ronald D. Smith, M.D., director of clinical research, Hypertension and Vascular Disease Center, Wake Forest University Baptist Medical Center, Winston-Salem, N.C.; April 2002 Journal of Neurology, Neurosurgery and Psychiatry
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