Macau Cardiology Association
What is the relationship between headaches and high blood pressure? Can high blood pressure cause headaches?

In the early 1900s, it was assumed that headaches were more common among people with high blood pressure. However, research into the subject has debunked this view. The best evidence available today indicates that high blood pressure does not cause headaches. According to one study, just the opposite appears to be true – people with high blood pressure seem to have significantly fewer headaches than the general population.

In a study published in the journal Neurology, people with higher systolic blood pressure (the larger or top number in blood pressure readings) were up to 40 percent less likely to have headaches compared to those with healthier blood pressure readings. The researchers also looked at another measurement called the pulse pressure, which is the change in blood pressure when the heart contracts. Pulse pressure is calculated by subtracting the bottom number (diastolic reading) from the top number (systolic reading). Those with higher pulse pressure had up to 50 percent fewer headaches. The researchers think that the higher the pulse pressure, the stiffer the blood vessels. The stiffer the blood vessel, the less likely the nerve endings are working properly. If the nerve endings aren’t functioning correctly, the less likely you will feel pain.

Extremely high blood pressure (at the level considered a hypertensive crisis – 180/110 mm Hg) may be accompanied by a headache – or it may not. Blood pressure this high is a medical emergency, and the person experiencing it should be hospitalized immediately. There is no safe duration for blood pressure to remain in this range. Do not wait to see if blood pressure comes down on its own. Do not wait to see if other symptoms develop. Call 9-1-1 immediately for emergency medical assistance. If you can’t access the emergency medical services (EMS), have someone drive you to the hospital right away. If you’re the one having symptoms, don’t drive yourself, unless you have absolutely no other option.

Another important point: High blood pressure is a leading risk factor for stroke, and one of the five warning signs of stroke is sudden, severe headache with no known cause. The other signs are:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination

If you or someone with you has one or more of these symptoms, call 9-1-1 immediately for emergency medical assistance and tell the operator you think it’s a stroke. If you can’t access the emergency medical services (EMS), have someone drive you to the hospital right away.

High blood pressure itself does not have symptoms. The only way to tell if you have high blood pressure is for a doctor to diagnose it after a period of monitoring.


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