Research suggests there is no causal link between high blood pressure and headaches, except in the rare case of malignant hypertension. Beta-blockers used to treat high blood pressure may even reduce the incidence of migraines. Coincidence and anxiety over a diagnosis of high blood pressure may be factors in the perceived link between the two conditions.
Somehow, it seems logical that high blood pressure causes headaches. Maybe it’s the word “pressure,” which is what a headache often feels like. Maybe it’s the feeling that the blood is churning and pounding against the inside of the skull.
Research into the phenomenon of “high blood pressure headaches” began as early as 1913, when physician Theodore Janeway identified “morning headaches” as a common symptom of hypertension. These headaches, he noted, seemed to lessen in severity as the day progressed. Janeway was a man of considerable credibility, one of the first professors of medicine at John’s Hopkins University. Yet that didn’t necessarily prove him right. Recent research seems to indicate that there is actually no causal link between hypertension and a high blood pressure headache.
A Polish study for the Journal of Human Hypertension, for example, hooked up 150 high blood pressure patients with portable monitors that ran continuously. By the end of the study, 43 reported having headaches, but when these cases were compared to blood pressure readings at the time, there appeared to be no correlation.
Much larger was a month-long survey of hypertension headaches conducted by the Journal of Neurology, Neurosurgery and Psychiatry, which extended to 22,000 adults and found no connection.
The one scary exception, it seems, is a condition called “malignant hypertension,” in which extremely high blood pressure swells the optic nerve behind the eye and can cause a blinding headache. This occurs in just 1 percent of people with hypertension, with young African-American males most at risk.
As for the other 99 percent, another study (from Norway) found that those with high blood pressure may actually have fewer headaches than a control group. That’s because beta-blockers, a popular family of blood pressure-lowering drugs, are also a primary clinical weapon against migraines.
Part of the alleged link between headache and high blood pressure could also be coincidence. People with severe headaches are more likely to visit a doctor or hospital, where blood pressure is measured. There is even speculation that anxiety about being diagnosed with high blood pressure can cause a “high blood pressure headache.” Some of the same diet and lifestyle factors can cause both.
However, Malcolm Law isn’t completely convinced. A professor of epidemiology at the University of London told WebMD: “My best guess is that high blood pressure causes headaches, but that’s just a guess.”
The preponderance of the evidence, however, strongly suggests that having a headache if you’re prone to high blood pressure is nothing to worry about. A couple of aspirins often put the matter to rest.
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