Relationship Between Headaches And Hypertension

Despite conflicting data on the relationship between headaches and hypertension, headaches are one of the most common symptoms of hypertension. The question is, does hypertension cause headaches? Currently, the evidence is unclear.

Research published in the American Journal of Hypertension shows no relationship between headaches and mild to moderate hypertension.¹

However, severe hypertension (where the systolic blood pressure is above 180mm Hg and/or the diastolic is above 120mm Hg) and abrupt rises in blood pressure have been attributed to causing headaches. 

The study suggests that if you have headaches and mild to moderate hypertension, you likely need to see your doctor find another cause for your headaches.

A hypertension headache is a pain, often occurring on both sides of the head, pulsating and getting worse with physical activity. The headache is typically accompanied by other symptoms associated with high blood pressure.

What are the symptoms of a hypertension headache?

Hypertension headaches often indicate high blood pressure or a hypertension crisis and should be handled as an emergency. For immediate attention, call 911 or go to the nearest emergency room. The following symptoms sometimes accompany hypertension headache:

  • Nosebleeds

  • Chest pain

  • Speech difficulties

  • Shortness of breath

  • Blurred vision

  • Numbness or tingling

  • Facial flushing

  • Blood spots in the eyes (subconjunctival hemorrhage)

The signs of hypertension headaches may intensify with physical activities such as coughing or body movements.

What are the causes of a hypertension headache?

The main cause of hypertension headache is high blood pressure — a blood pressure higher than 180/110mm Hg.² Hypertension headache may also result from other factors, such as:

  • Pheochromocytoma, i.e., malignant or benign tumors on the adrenal glands

  • Severe increase in blood pressure without damage or disease of the brain

  • Severe increase in blood pressure causing damage or disease of the brain

  • Pre-eclampsia and eclampsia, i.e., a sudden increase in blood pressure in third-trimester pregnant mothers and post-delivery mothers

  • Critical blood pressure response to external factors such as the use of or withdrawal from drugs  

Is hypertensive headache an emergency?

Hypertensive headache is an emergency, and you should not self-medicate other than taking your usual blood pressure medications prescribed by your doctor. You should only take over-the-counter drugs, such as aspirin, with regular blood pressure.

Hypertension headaches might indicate a hypertension crisis — a severe increase in blood pressure, which can cause stroke and damage to vital organs.

If you suspect you have a hypertension headache, you should seek immediate medical attention from your doctor to gauge whether your condition needs urgent treatment.

How is hypertension headache treated?

Doctors classify hypertension headache as a secondary headache and as a hypertensive emergency. The condition requires gradual lowering of blood pressure through intravenous (IV) medication.

Common  IV medications used on hypertensive headache patients include:

  • Nitroglycerin

  • Sodium nitroprusside

  • Nicardipine

  • Labetalol

Fast reduction of blood pressure can be fatal, and the effects of the medical therapies need to be monitored. Report to the emergency room near you to have doctors lower your blood pressure safely and in a controlled environment.

Changing your lifestyle, however, can help you avoid hypertension headaches.

How to prevent hypertension headaches

Hypertension is a lifestyle-based disease and can be managed by a change in lifestyle. It is possible to reduce the frequency and manage hypertension headaches on your own in the following ways:

Responding quickly to headaches

The first thing you should do is determine whether your headache is caused by severe high blood pressure or if it is caused by something else like stress, dehydration, eye strain, or migraines.  If you experience headaches, you can check your blood pressure level to determine your next step.

You can take over-the-counter painkillers such as ibuprofen or acetaminophen if your blood pressure is lower than 180/120mm Hg. If you suffer from migraines and have been prescribed triptan medication, take a single dose immediately if you feel a headache.

You should talk to your doctor about which over-the-counter drugs are safe to use and whether you can mix them with your current medications.

Sometimes, disassociating yourself from the chaotic environment can help you manage your headaches. Find a peaceful, dark, and cool place to lie down. Shut out your thoughts for a minute, and relax. If the headache is mild, it should go away with this.

If you are experiencing a hypertension crisis, over-the-counter medication and calming down will not work. Access emergency medical attention if you experience chest pains, nausea, distorted vision, or other extreme symptoms.

Lowering your blood pressure

Talk to your doctor about managing and lowering your blood pressure at home. Change in lifestyle combined with the correct medication will help keep your blood pressure at normal levels.

Make it a habit of performing regular physical exercise such as walking or jogging, and adhere strictly to the diet plan given to you by your doctor. Additionally, talk to your doctor about whether potassium and magnesium supplements might be helpful. Your diet and certain medications can affect the balance of these minerals.

Your doctor may also recommend certain dietary changes or supplements, which may help you ease muscle tension, enhance sleep quality, and control hypertension headaches long-term.

When to see a doctor

A hypertension crisis, if left untreated, can cause irreversible damage to your body. Examples of severe side effects of an untreated hypertension crisis include:

Do not ignore severe, constant headaches or any other symptoms of high blood pressure. If you experience these symptoms, call 911 for immediate assistance.

The lowdown

If you have a bad headache, the first thing you should look out for is whether it could be related to severe high blood pressure. If your blood pressure is above 180/120 mmHg, this is a medical emergency and could cause long-term damage to your organs. Please call 911 or attend your local emergency room immediately.


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