Related Experiment Video
Updated: Jul 15, 2026
07:00
A Laser-induced Mouse Model of Chronic Ocular Hypertension to Characterize Visual Defects
Published on: August 14, 2013
Systemic hypertension, headache, and ocular hemodynamics: a new hypothesis
1Dubai Police Medical Services, Dubai, United Arab Emirates. dr_vkgupta@yahoo.com
Medgenmed : Medscape General Medicine
|April 5, 2007
Summary
Systemic hypertension may cause morning headaches due to ocular sympathetic hypofunction leading to choroidal overperfusion. Higher intraocular pressure in some hypertensive patients may explain the negative association between hypertension and headache.
Area of Science:
- Ophthalmology
- Neurology
- Cardiology
Background:
- The link between systemic hypertension and headache is debated, with some studies showing a positive association and others a negative one.
- Headache and neck pain often involve the ophthalmic division of the trigeminal nerve (V1).
- Systemic hypertension, pulsatile choroidal blood flow (CBF), and intraocular pressure (IOP) are interconnected.
Purpose of the Study:
- To propose a novel hypothesis for the pathophysiologic basis of headache in hypertensive patients.
- To explain the paradoxical epidemiologic findings linking hypertension and headache.
- To suggest a mechanism involving ocular sympathetic hypofunction and choroidal overperfusion.
Main Methods:
- The study proposes a hypothesis based on existing literature and neuroanatomical pathways.
- It suggests evaluating the hypothesis by measuring blood pressure and IOP during headache attacks in hypertensive patients.
- The proposed mechanism involves ocular sympathetic hypofunction, choroidal overperfusion, and trigeminal nerve stimulation.
Main Results:
- A trait ocular sympathetic hypofunction may lead to episodic choroidal overperfusion, stretching the ocular globe and stimulating V1 nerve endings, causing headache in hypertensive individuals.
- Higher basal IOP in some hypertensive patients might dampen pulsatile CBF, potentially explaining the negative epidemiologic association between hypertension and headache.
- Hypalgesia associated with hypertension may involve the vasopressin-endorphin system due to V1 mechanical stimulation.
Conclusions:
- The proposed hypothesis offers a potential explanation for hypertension-related headaches, particularly morning headaches.
- It differentiates hypertensive headache from angle-closure glaucoma, noting differences in ocular signs and CBF.
- Further research measuring circadian blood pressure and IOP patterns in patients with hypertensive headaches is recommended for validation.
Related Concept Videos
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
01:29Hypertension II: Pathophysiology
Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
01:30Alterations in Blood Pressure
Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart beats)...
01:25Glaucoma: Overview
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
01:28Hypertension I: Introduction
Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...