Background Headache is regarded as a most frequent symptom of high blood pressure. The aim of the study was to assess frequency and localization of headache in ambulatory treated patients with essential hypertension. Moreover, we investigated factors related to the frequency of headaches and tested the hypothesis that headaches occur more frequently at the same side of the head that the higher BP on arm.
Material and methods 364 consecutive hypertensive patients (treated with antihypertensive drugs in out-patient clinic for at least 6 months), 198 males (57.2 ± 11.0 years) and 166 females (59.0 ± 11.6 years) were included. According to BP values obtained at the office in standard conditions, all the patients were allocated into 3 groups: with higher BP at left arm (L), with higher BP at right arm (P) and with similar BP values at both arms (R) (£ 9 mm Hg difference between arms). Headache episodes (with duration of each period in hours) and all drugs used by the patients (antihypertensives and other) during 1 month were self-recorded in the special diary (structuralized questionnaire).
Results During the last month headache episodes were reported by 308 (84.6%) patients (mean 15.3 ± 8.5 episodes per month, range 1–52). Most of the patients (140 persons, 45.5%) reported from 1 to 10 headaches in the month. Headaches have more often appeared in forehead area (44.5%) than in occipital area (23.7%) in all examined groups L, P and R (p < 0.01). The highest frequency of headaches was observed in patients with higher values of BP on the left arm (19.1/month), next on right (11.8/ /month), and most rarely with equal values of BP on both arms (7.0/month) (p < 0.01). Analysing the impact of all drugs taken (from 1 to 10) we stated that headaches had most rarely reported in patients treated with 1 and 2 drugs. Headaches were more frequent in women (r = 0.27, p < 0.05) and patients with higher DBP values (r = 0.29, p < 0.05). After taking the age and the sex into account only a link between the treatment with fixed-dose combined antihypertensive drugs and the lower frequency of headaches was found (r = –0.19, p < 0.05).
Conclusions Headaches are frequently experienced by ambulatory treated hypertensive patients, mainly in the forehead area, in women and in those with higher diastolic BP. However, only a weak relation between localization of headache the right temple in persons with higher BP at right arm was found. Patients treated with fixed-dose combined antihypertensive drugs had lower incidence of headaches than those treated with four main classes of antihypertensive drugs.
Arterial Hypertension 2011, vol. 15, no 2, pages 102–111.