Saturday, November 19, 2005

Hypertensive headache?

We were traditionally taught that hypertension is a silent killer, and that the notion of hypertensive headache is a myth. This meta-analysis in Circulation reports that antihypertensive treatment prevents headache, NNT=30, without regard to antihypertensive class. Four classes of medication with differing mechanisms of action were studied. Maybe our patients knew what they were talking about all along.

7 comments:

Moof said...

About HTN and headaches ...

A long time ago, with no previous history of HTN or headaches, I had a doozy "ice pick in the back of my head" type of head ache that drove me straight to the ER in the middle of the night. The systolic was somewhat over 200. They brought it down, and I went home. End of story.

However, two years ago, at what was my first real visit with a physician in about 16 years, with no pain - no hint that anything was wrong - I had 280/160. It took them 6 days, with me in the hospital, to get it under 200/90.

Have had to fight severe HTN ever since, but never another "ice pick" since that first bout nearly 2 decades before.

I will tell you, however ... I remember that first headache as being more painful than a migraine - exquisitely agonizing.

If your patients complain about headaches with their HTN, because of that one experience, I would say that if you ignore them, you could be ignoring the worst pain they've ever experienced in their lives ...

... something akin to a very bad toothache somewhere in the area of where your neck meets your head in the back. Nasty.

R. W. Donnell said...

Thanks for the comment. Folks have been telling docs that their high BP causes headaches, for a long time, and the study I cited suggests that indeed there's evidence to support the association. For most folks, however, hypertension is asymptomatic while it's doing its damage, which is why we stress monitoring and treatment regardess of symptoms

Dr. Oz said...

the relationship between headaches and hypertension has been a contentious issue among healthcare professionals for many years. recent studies have shown however that there is little to suggest that headaches are directly linked elevated blood pressure levels.i completely agreee that severe headaches do occur in severe/malignant hypertension though. thanks for sharing your experience.
dr oz www.hypertensionzone.com

Anonymous said...

I've been suffering from hypertensive headaches for about five years know. I'm sure everyone is saying "why don'nt you take medications to relieve the pain and reduce the hypertension". We'll I do. I've been from A to Z as far as blood pressure med's are concern and in combination with prevenitive med's for the migrains, all med's will work for a while (about 2months) and then the cycle just repeats it self all over again. It's almost like my body gets immune to the med's they just stop working. Sometimes the med's will no longer continue to work after a two week period of time. I get migrains about 1-2 times a week and when I do,it triggers my b/p to sky rocket. I'm talking about stroke conditions (210/145).

Due to my condition 4 years ago I decided to change my life around and start making healthier choices my Dr. told me that loosing weight would fix my problems and my hypertension and headaches will go away. So I took his advice and went on a diet. I went from a size 20 to a size 9/10 but what good is loosing the 90 pounds if im not going to be around to enjoy the next few years.Im still get headaches often and my blood pressure will not stay under control. Help me!!!!!!!!


A migrainist in need of help

Em Dizzle said...

I experienced a hypertensive reaction to a drug drug (peganum harmala [maoi] and alcohol [tyramine]) interaction a year ago and have been experiencing NPDH ever since. Any ideas? I have had the full workup: MRI, CT, lumbar puncture(pressure:21), and blood work.

Anonymous said...

>the notion of hypertensive >headache is a myth

Who's the MORON that wrote that
statement? Has to be the same person that said steriods are good for you while in reality they distroy the immune system and bones?

I can tell when my blood pressure goes high and have known for years. When I first found out the nurse came in and tested my BP. She did it again and looked at me strange. She went out and another nurse came in and ran my BP. It was 240 over 120. You know what she said, how are you feeling. I said I have a headake. I had a lack of potassium.

I had been checking my BP for years. It was a little high when they gave me a drug like Lyrica that knocked me out then stroked me. Guess what I asked right after? How is my BP, I have a spliting headake.

Ask anyone that has HBP ask them if they get a headake when they take off or miss their BP pill.

Want more look up what the chinese have to say about "Gou Teng Wan". (It is used for deficiency of Yin leading to hyperactivity of Yang, stirring up of endogenous wind in the liver, headache, dizziness, tinnitus, blurred vision, palpitation, insomnia, hemiplegia and hypertensive headache).
!!!!!!!!!!!!!!!!!!!!!

Want to know even more? The headakes that come from the HBP are mostly in the back of the head just at the spine stem.

DRS

Anonymous said...

>the notion of hypertensive >headache is a myth

Who's the MORON that wrote that
statement? Has to be the same person that said steriods are good for you while they distroy the immune system and bones?

I can tell when my blood pressure goes high and have known for years. When I first found out the nurse came in and tested my BP. She did it again and looked at me strange. She went out and another nurse came in and ran my BP. It was 240 over 120. You know what she said, how are you feeling. I said I have a slight headake. I had a lack of potassium.

I had been checking my BP for years. It was a little high when they gave me one like Lyrica that knocked me out then stroked me. Guess what I asked right after? How is my BP, I have a spliting headake.

Ask anyone that has HBP ask them if they get a headake when they take off or miss their BP pill.

Want more look up what the chinese have to say about "Gou Teng Wan". (It is used for deficiency of Yin leading to hyperactivity of Yang, stirring up of endogenous wind in the liver, headache, dizziness, tinnitus, blurred vision, palpitation, insomnia, hemiplegia and hypertensive headache).
!!!!!!!!!!!!!!!!!!!!!

Want to know more? The headakes that come from the HBP are mostly in the back of the head just at the spine stem.

DRS