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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2002 Apr;72(4):463–466. doi: 10.1136/jnnp.72.4.463

Blood pressure and risk of headache: a prospective study of 22 685 adults in Norway

K Hagen 1, L Stovner 1, L Vatten 1, J Holmen 1, J Zwart 1, G Bovim 1
PMCID: PMC1737809  PMID: 11909904

Abstract

Objectives: Prevalence studies of the association between blood pressure and headache have shown conflicting results. The aim was to analyse the relation between blood pressure and risk of headache in a prospective study.

Methods: A total of 22 685 adults not likely to have headache, had their baseline blood pressure measured in 1984–6, and responded to a headache questionnaire at follow up 11 years later (1995–7). The relative risk of headache (migraine or non-migrainous headache) was estimated in relation to blood pressure at baseline.

Results: Those with a systolic blood pressure of 150 mm Hg or higher had 30% lower risk (risk ratio (RR)=0.7, 95% CI 0.6–0.8) of having non-migrainous headache at follow up compared with those with systolic pressure lower than 140 mm Hg. For diastolic blood pressure, the risk of non-migrainous headache decreased with increasing values, and these findings were similar for both sexes, and were not influenced by use of antihypertensive medication. For migraine, there was no clear association with blood pressure.

Conclusion: In the first prospective study of blood pressure and the risk of headache, high systolic and diastolic pressures were associated with reduced risk of non-migrainous headache. One possible explanation may be the phenomenon of hypertension associated hypalgesia, which probably involves the baroreflex system influencing nociception in the brain stem or spinal cord.

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Selected References

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  1. ATKINS J. B. Migraine as a sequel to infection by L. icterohaemorrhagiae. Br Med J. 1955 Apr 23;1(4920):1011–1012. doi: 10.1136/bmj.1.4920.1011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Abramson J. H., Hopp C., Epstein L. M. Migraine and non-migrainous headaches. A community survey in Jerusalem. J Epidemiol Community Health. 1980 Sep;34(3):188–193. doi: 10.1136/jech.34.3.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Antonov K., Isacson D. Headache and analgesic use in Sweden. Headache. 1998 Feb;38(2):97–104. doi: 10.1046/j.1526-4610.1998.3802097.x. [DOI] [PubMed] [Google Scholar]
  4. Badran R. H., Weir R. J., McGuiness J. B. Hypertension and headache. Scott Med J. 1970 Feb;15(2):48–51. doi: 10.1177/003693307001500202. [DOI] [PubMed] [Google Scholar]
  5. Bulpitt C. J., Dollery C. T., Carne S. Change in symptoms of hypertensive patients after referral to hospital clinic. Br Heart J. 1976 Feb;38(2):121–128. doi: 10.1136/hrt.38.2.121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Celentano D. D., Stewart W. F., Lipton R. B., Reed M. L. Medication use and disability among migraineurs: a national probability sample survey. Headache. 1992 May;32(5):223–228. doi: 10.1111/j.1526-4610.1992.hed3205223.x. [DOI] [PubMed] [Google Scholar]
  7. Chen T. C., Leviton A., Edelstein S., Ellenberg J. H. Migraine and other diseases in women of reproductive age. The influence of smoking on observed associations. Arch Neurol. 1987 Oct;44(10):1024–1028. doi: 10.1001/archneur.1987.00520220030011. [DOI] [PubMed] [Google Scholar]
  8. Cirillo M., Stellato D., Lombardi C., De Santo N. G., Covelli V. Headache and cardiovascular risk factors: positive association with hypertension. Headache. 1999 Jun;39(6):409–416. doi: 10.1046/j.1526-4610.1999.3906409.x. [DOI] [PubMed] [Google Scholar]
  9. Couch J. R., Hassanein R. S. Headache as a risk factor in atherosclerosis-related diseases. Headache. 1989 Jan;29(1):49–54. doi: 10.1111/j.1526-4610.1989.hed2901049.x. [DOI] [PubMed] [Google Scholar]
  10. Espir M. L., Thomason J., Blau J. N., Kurtz Z. Headaches in civil servants: effect on work and leisure. Br J Ind Med. 1988 May;45(5):336–340. doi: 10.1136/oem.45.5.336. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Featherstone H. J. Medical diagnoses and problems in individuals with recurrent idiopathic headaches. Headache. 1985 May;25(3):136–140. doi: 10.1111/j.1526-4610.1985.hed2503136.x. [DOI] [PubMed] [Google Scholar]
  12. Franceschi M., Colombo B., Rossi P., Canal N. Headache in a population-based elderly cohort. An ancillary study to the Italian Longitudinal Study of Aging (ILSA). Headache. 1997 Feb;37(2):79–82. doi: 10.1046/j.1526-4610.1997.3702079.x. [DOI] [PubMed] [Google Scholar]
  13. Ghione S. Hypertension-associated hypalgesia. Evidence in experimental animals and humans, pathophysiological mechanisms, and potential clinical consequences. Hypertension. 1996 Sep;28(3):494–504. doi: 10.1161/01.hyp.28.3.494. [DOI] [PubMed] [Google Scholar]
  14. Hagen K., Zwart J. A., Vatten L., Stovner L. J., Bovim G. Head-HUNT: validity and reliability of a headache questionnaire in a large population-based study in Norway. Cephalalgia. 2000 May;20(4):244–251. doi: 10.1046/j.1468-2982.2000.00049.x. [DOI] [PubMed] [Google Scholar]
  15. Hale W. E., May F. E., Marks R. G., Moore M. T., Stewart R. B. Headache in the elderly: an evaluation of risk factors. Headache. 1987 May;27(5):272–276. doi: 10.1111/j.1526-4610.1987.hed2705272.x. [DOI] [PubMed] [Google Scholar]
  16. Ho K. H., Benjamin K. C. Perceived headache associations in Singapore: results of a randomized national survey. Headache. 2001 Feb;41(2):164–170. doi: 10.1046/j.1526-4610.2001.111006164.x. [DOI] [PubMed] [Google Scholar]
  17. Jaillard A. S., Mazetti P., Kala E. Prevalence of migraine and headache in a high-altitude town of Peru: a population-based study. Headache. 1997 Feb;37(2):95–101. doi: 10.1046/j.1526-4610.1997.3702095.x. [DOI] [PubMed] [Google Scholar]
  18. Kottke T. E., Tuomilehto J., Puska P., Salonen J. T. The relationship of symptoms and blood pressure in a population sample. Int J Epidemiol. 1979 Dec;8(4):355–359. doi: 10.1093/ije/8.4.355. [DOI] [PubMed] [Google Scholar]
  19. Kryst S., Scherl E. A population-based survey of the social and personal impact of headache. Headache. 1994 Jun;34(6):344–350. doi: 10.1111/j.1526-4610.1994.hed3406344.x. [DOI] [PubMed] [Google Scholar]
  20. Marcoux S., Bérubé S., Brisson J., Fabia J. History of migraine and risk of pregnancy-induced hypertension. Epidemiology. 1992 Jan;3(1):53–56. doi: 10.1097/00001648-199201000-00010. [DOI] [PubMed] [Google Scholar]
  21. Markush R. E., Karp H. R., Heyman A., O'Fallon W. M. Epidemiologic study of migraine symptoms in young women. Neurology. 1975 May;25(5):430–435. doi: 10.1212/wnl.25.5.430. [DOI] [PubMed] [Google Scholar]
  22. Paulin J. M., Waal-Manning H. J., Simpson F. O., Knight R. G. The prevalence of headache in a small New Zealand town. Headache. 1985 May;25(3):147–151. doi: 10.1111/j.1526-4610.1985.hed2503147.x. [DOI] [PubMed] [Google Scholar]
  23. Rasmussen B. K. Epidemiology of headache. Cephalalgia. 1995 Feb;15(1):45–68. doi: 10.1046/j.1468-2982.1995.1501045.x. [DOI] [PubMed] [Google Scholar]
  24. Rasmussen B. K., Jensen R., Olesen J. Impact of headache on sickness absence and utilisation of medical services: a Danish population study. J Epidemiol Community Health. 1992 Aug;46(4):443–446. doi: 10.1136/jech.46.4.443. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Rasmussen B. K., Olesen J. Symptomatic and nonsymptomatic headaches in a general population. Neurology. 1992 Jun;42(6):1225–1231. doi: 10.1212/wnl.42.6.1225. [DOI] [PubMed] [Google Scholar]
  26. Schéle R., Ahlborg B., Ekbom K. Physical characteristics and allergic history in young men with migraine and other headaches. Headache. 1978 May;18(2):80–86. doi: 10.1111/j.1526-4610.1978.hed1802080.x. [DOI] [PubMed] [Google Scholar]
  27. Wang S. J., Fuh J. L., Lu S. R., Liu C. Y., Hsu L. C., Wang P. N., Liu H. C. Chronic daily headache in Chinese elderly: prevalence, risk factors, and biannual follow-up. Neurology. 2000 Jan 25;54(2):314–319. doi: 10.1212/wnl.54.2.314. [DOI] [PubMed] [Google Scholar]
  28. Waters W. E. Headache and blood pressure in the community. Br Med J. 1971 Jan 16;1(5741):142–143. doi: 10.1136/bmj.1.5741.142. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Weiss N. S. Relation of high blood pressure to headache, epistaxis, and selected other symptoms. The United States Health Examination Survey of Adults. N Engl J Med. 1972 Sep 28;287(13):631–633. doi: 10.1056/NEJM197209282871303. [DOI] [PubMed] [Google Scholar]
  30. Ziegler D. K., Hassanein R. S., Couch J. R. Characteristics of life headache histories in a nonclinic population. Neurology. 1977 Mar;27(3):265–269. doi: 10.1212/wnl.27.3.265. [DOI] [PubMed] [Google Scholar]

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