Relationship of headache to hypertension

Objective: The aim of the present study was to assess the prevalence of hypertension in adult patients presenting with headache. Place and duration of study: Private clinic of the author from January 2002 to December 2003. Patients and Methods: A total of 972 patients with headachewere examined and blood pressure was measured by standard mercury sphygmomanometerin all the patients. The patients were labeled as hypertensive and normotensive according to JNC-7 guidelines.Based on the history headachewas diagnosed according to International HeadacheSociety guidelines and was clinically divided as migrainousand (non- migrainous) tension headache. Results: Of the 972 patients, 261 patients were clinically diagnosed as having migraineand 711 patients as having (non- migrainous) tension headache. The total number of hypertensive patients were 195 (20.06%) and the total number of normotensive patients were 777 (79.94%). Hypertension was also graded accordingly as Stage-I and Stage-II. There were 112(11.52%) patients with stage-I hypertension and 83(8.53%) patients with stage-II hypertension. Of the patients clinically diagnosed as migraineonly 11(1.13%) patients had Stage-I hypertension while 4(0.41%) had Stage-II hypertension. Of the patients diagnosed as (non- migrainous) tension headacheshad Stage-I hypertension in 101 patients(10.39%) while Stage-II hypertension in 79(8.13) patients. Two hundred and forty six(25.31%) Migraineur and 531 (54.63%) non-migraneurs had normal blood pressure. Five hundred and thirty one patients had no hypertension and were labeled as normal.The total Odds ratio for hypertension in headachewas 0.1799( 95% CI Range: 0.104-0.3112). For hypertension the sensitivity of (non- migrainous) tension headacheis 92% and a specificity of 32%. This is only 68% and 7% for migrainous headache. Conclusion: A large number of patients with headacheare normotensive and thus headacheshould not be considered as a very important symptom of hypertension as the myth prevails in our society