Headaches Caused by High Blood Pressure

HYPERTENSION (HIGH BLOOD PRESSURE) AS A CAUSE OF HEADACHES

Very occasionally, I have had a patient who tells me they have a headache (sometimes accompanied by a ringing or "whooshing" sound in the ears or ears). When I check their blood pressure, it is extremely high (160s-180s/110s-120s). Those numbers are, basically, stroke material, and I send these patients quickly on to urgent care or ER (of course, this makes their blood pressure even higher). This kind of headache is described as “pulsating” on both sides or within the top of the head. Sources say that most people with high blood pressure generally do not get headaches (they also say they do not get facial flushing much, but look at all of those heavy-set set flushed NFL coaches!!).

If you are getting periodic headaches, check your blood pressure once or twice a day over several days (ideally, once in the morning and once in the evening). Jot your readings down. If your blood pressure is consistently over 140/90, discuss it with a healthcare provider. Over time, high blood pressure causes damage to your body.

A Headache Caused by High Blood Pressure

Treating the Potential Cause

If your blood pressure is just a bit high, your healthcare provider will often recommend lifestyle changes for three months, like lower salt (do not add salt to meals, watch canned foods, read labels), exercise, and, if you are overweight, lose some pounds. In the meantime, continue to monitor your blood pressure. In three months, your provider will want to see you again. If your blood pressure is good, your doctor will advise you to continue "good habits." If your blood pressure is high, your healthcare provider will likely start you on blood pressure medicine.

While you may not want to be on blood pressure medicine, this is a good thing because, over time, be assured that blood pressure will cause more than just headaches: It will cause eye damage, kidney damage, and heart problems over time (and, in most cases, you won't even know that is happening!).

And, as much as you might hate it, if either or both numbers are over 180/120, go to the ER. (Exertional hypertension may be an exception, but be sure your BP is coming down after your exercise).

Note: Those with high blood pressure should have a blood pressure monitor at home if possible (preferably one for the upper arm - they tend to work better).

If you have headaches related to high blood pressure, the headaches should go away when blood pressure is under control. In the meantime, you can try some of the following.

General Recommendations 

For headaches caused by high blood pressure, consider the following adjunctive management techniques:

• Alter your surroundings - avoid stress if at all possible

• Rest in a dark, quiet, and comfortable place when you feel a headache coming on.

• Use relaxation and deep breathing techniques.

  -Try Progressive Muscle Relaxation Exercises: This is done by tightening muscle groups for eight seconds then relaxing them for several seconds: Begin with facial muscles, with the face, moving to the scalp - tighten muscles eight seconds, then relax; then the neck, doing with each muscle group of the chest, back, pelvis, extremities and so on. This releases some tension and stress. If you do not have time to move through all of your muscle groups, do this with those muscles you believe have the most tension.

• -Pressure Points: One approach sometimes used to relieve these headaches is that of using a pressure point. Pressure point LI-4 is also called Hegu (her-goo). It is found on the back of your hand. It is between the base of your thumb and index (pointer) finger. Doing acupressure on this point can help with pain and headaches. Other pressure points can be found here.

• -Deep breathing exercises - This helps release endorphins in your brain, which are"feel good" hormones. This technique is practiced by taking a deep breath through your mouth using your diaphragm muscle located just beneath your lower ribs (instead of using neck, shoulder and upper chest muscles), pausing and then releasing the breath through the mouth. Repeat this several times.

• Cold compresses (to head or neck) - 15-20 minutes at a time.

• Hydrate well

Over-the-Counter Medications

Be aware that non-steroidal anti-inflammatory drugs (NSAIDs), while effective for headaches, are generally NOT recommended for people with significant hypertension because they can interfere with mechanisms that control blood pressure, causing it to rise. NSAIDs can also contribute to kidney problems, and the kidneys play a big role in controlling blood pressure. These include ibuprofen (common: Advil, Motrin), naproxen sodium (common: Aleve, Naprosyn), and the combination of caffeine, acetaminophen, and Aspirin (common: Excedrin Migraine, Goody’s Powder). Again, while these are popular medications for headaches, if you have high blood pressure, they may not be the best for you.

Acetaminophen (common: Tylenol). 

This is a good choice for headaches. Take acetaminophen over-the-counter, as directed. Read the label for any contraindications (especially liver problems)

Try to treat the headache early on: It is easier to stop pain if you attack it early rather than waiting until it is full-blown.

Considered Natural Remedies:

• Magnesium

• Caffeine

• Peppermint Oils

• Lavender

• Ginger

• Chamomile

Prescription medications

A healthcare provider will prescribe one of many antihypertensive medications to lower blood pressure and may prescribe medication to minimize headaches.

When to See a Healthcare Provider

RED FLAGS

• A “thunderclap” headache – sudden severe onset - a "10 out of 10" - go to ER

• ​Do not dismiss frequent or severe headaches, especially if accompanied by

• Vomiting (especially projectile- a forceful outward-directed emesis )

• Double vision

• Change in your level of consciousness or change in behavior

• Recent head injury

• History of a stroke

• It is new and lasting for a few days (especially in the absence of a viral or bacterial infection)

• Is excruciating

• Has become  chronic/ongoing and does not respond to medicines

• If headaches especially occur after exercise_

• New onset of headaches after 50 (according to the American Headache Society)

• If you have more than one to two headaches a week or more than three to four per month 

• If you have less frequent headaches, but they are more severe and debilitating

• Your headaches start to feel different than your "usual" headaches