Headache and Hypertension in the Emergency Service

Abstract

Background: Headache and hypertension are common complaints in general population which represent the majority of the reasons of claims ta general polyclinics and emergency rooms. Although headache is generally regarded as a symptom of high blood pressure, there has been a debate on the association of hypertension and headache for many years. Main conflicting topics are the common existence of headache and hypertension as well as the frequent complaining of hypertensive patients from headache.
Objective: To investigate the existence of hypertension in the patients with the complaint of headache, as well as the co­morbidity of headache in the patients with hypertension complaint who attend ta the emergency room and the clinical features of both situations.
Material and Methods: Four hundred consecutive patients whattended to the emergency room of our faculty with headache or hypertension were included to our study. The diagnosis of hypertension was made by using JNC-VII (Joint National Committee) criteria, while the headache was diagnosed by IHS (lnternational Headache Society) criteria. Results: The arterial blood pressure of 131 of 186 patients who attended to the emergency room with headache were found elevated whose majority were at the prehypertensive grade according to the JNC-VII criteria. Only 12 of these patients were diagnosed as chronic hypertension and were taking antihypertensive treatment. Absence of another reason that could explain the hypertension in the remaining 119 patients was suggesting that the headache was elevating the arterial blood pressure simultaneously. Similarly, in the examination of 214 patients who attended to the emergency room with hypertension complaint, simultaneous headache was found in 62 patients. Only 5 of them had chronic headache, while the majority of the patients had no other reason that could explain headache except hypertension. This was suggesting the idea that elevation of blood pressure was the reason of headache. The existence of headache in hypertensive patients as well as the elevation of blood pressure in the patients with headache is provoking that both situations can trigger each other and there can be a common mechanism between two situations.