Can High Blood Pressure Cause Headaches?

What is high blood pressure (Hypertension)?

When we breathe in, oxygen is taken in and travels from our lungs to get into our bloodstream. The heart pumps blood to all parts of our body through blood vessels, providing our organs with oxygen to enable them to function better. 

High blood pressure (HBP) or hypertension is a condition where your heart pumps blood faster than normal, making the force of the blood against the walls of your artery (the vessel that carries blood away from the heart) more intense. 

High blood pressure can also be genetic or caused by environmental or medical factors. This is called secondary hypertension.

To check your blood pressure, a blood pressure monitor is used. The result of this test is presented in figures and measured in mmHg (millimetre of mercury). 

Normal blood pressure is below 120/80mmHg and above 90/60mmHg. Any value below the latter indicates low blood pressure.

The upper value of a blood pressure test result (120 or 90) is the systolic pressure, this measures how much force your blood is passing through your arteries when the heart beats. 

The lower value (80 or 60) called the diastolic pressure, measures the force when your heart is resting between each beat.

Stages of high blood pressure

According to the American Heart Association, there are four stages of high blood pressure.¹ 

1. Elevated stage: There is an elevation in your blood pressure when your results are between 120-129 for the systolic pressure and less than 80 for the diastolic blood pressure.
2. Hypertension stage 1: At this stage, the systolic reads between 130-139 and the diastolic reads between 80-90.
3. Hypertension stage 2: In this stage, it is mild hypertension if the reading is 140/90 or above, and moderate hypertension when systolic is 160-179 with diastolic is between 100-109 mmHg.
4. Hypertensive crisis: When your blood pressure is suddenly above 180/120, do not wait to see if your blood pressure reduces like in the other stages above. This requires medical attention as it can be critical if not contained.

Symptoms

• Severe headache
• Irregular heartbeat
• Dizziness
• Chest pain
• Breathlessness
• Sleepiness or insomnia
• Fatigue
• Ringing in ears
• Visual changes
• Sweating
• Restlessness
• Involuntary movements

High blood pressure is a silent killer: It is worthy to note that some patients may have high blood pressure without knowing because they are asymptomatic: they are not showing any signs or symptoms. 

This is why it is advised that you do a routine blood pressure test. 

A paper cited by Mayo Clinic gives an overview of how frequently you should do a blood pressure test, depending on your age, and how to prepare yourself for the test.²

High blood pressure and headaches

Does high blood pressure cause headaches?

Primary headaches such as tension, migraine and cluster headaches are not caused by any underlying illness. They may be caused by stress, weather, environment or tightened muscles. 

Tension headaches are more common and usually go away on their own after you take a rest or make a lifestyle change (if they occur more often).

Secondary headaches are a more severe form of headache and are associated with various illnesses that lead to sudden, severe, and occasional increases in blood pressure.

There has been contradicting evidence as to whether high blood pressure causes hypertension headaches.

The American Heart Association maintains that unless your blood pressure is above 180/120, you will not experience any headaches.¹ 

The authors of a paper published in the Journal of Blood Pressure state that the results of their research did not support the possibility of elevated blood pressure causing headaches in stage 1-2 hypertensives.³ They further stated that the direct processes of headache in hypertension, as well as the link between increased blood pressure higher than 180/110 mmHg and headache, require extensive investigations.

As explained in an article by the Iranian Journal of Neurology, a sudden increase of blood pressure in the artery is responsible for headaches rather than the value in your test result.⁴ The authors are of the opinion that high blood pressure can cause headaches because it affects the amount of blood (and oxygen) getting to the brain.

What is the link between high blood pressure and headaches?

In severe cases where blood pressure is extremely high, hypertension can result in excess pressure on the brain. This causes blood to leak from the blood vessels in the brain. This leakage causes swelling, which can lead to Intracranial Hypertension (IH) - when pressure builds up in the brain.

The swelling places further pressure on the brain and causes symptoms that include headaches, confusion, weakness, dizziness, nausea, blurred vision and seizures. However, if a person receives treatment for high blood pressure, they will most likely feel better within an hour.

Do headaches cause high blood pressure?

The physical stress of a headache or any associated pain could be a risk factor for elevated blood pressure. This may be part of the body’s response to pain.

Research is ongoing to fully understand the link between headaches and high blood pressure. It is not clear which causes which or if they are both caused by other factors.

Dr. Luke Laffin, a cardiologist at the Cleveland Clinic states that what we should consider about headaches and blood pressure is that it could be an egg and chicken scenario, where we do not know which comes first.⁵  

The American Journal of Hypertension studied 1,914 people with high blood pressure and monitored their headaches over a period of 30 years.⁶ Results indicated that there was no link between their regularly occurring headaches and the likelihood of them having a heart attack or heart failure from elevated blood pressure.

Treatment for high blood pressure-related headaches

If you have been diagnosed with hypertension, you should be mindful of what medications you take to avoid complications.⁷ Aspirin and acetaminophen are some over-the-counter medications you could take for pain relief. If you need other medication options, talk to your healthcare provider.

Lifestyle changes such as exercising, getting enough sleep, limiting or avoiding alcohol and smoking, a low-fat diet, or taking high blood pressure medication prescribed after diagnosis are all potential treatments, as well.

Complications 

In the event of a persistent headache, or malignant hypertension (a sudden elevation in high blood pressure) seek medical attention, as it could be a hypertensive emergency. Stroke, heart failure and dementia are some complications that can arise from untreated high blood pressure.

Headaches could also be an indication of other underlying conditions such as kidney disease or supine hypertension, whereby a person’s blood pressure elevates whenever they lie down. This can be seen in people with sleep apnoea who may experience both migraine and hypertension in the morning.

Summary

The answer to whether high blood pressure can cause headaches has not entirely been answered; however, we do know that one may cause the other. This varies among individuals depending on their heart health, blood pressure, and if they have any underlying health issues. 

Researchers advise that recurring headaches may be an indication that it is necessary to seek medical attention. It is best to speak with your healthcare provider if you experience two or more of the symptoms listed earlier. 

It is crucial to pay close attention to our bodies so we are able to quickly notice even the slightest change in the way our body functions.