Headache and arterial hypertension

Elevated blood pressure (BP) and headache have long been linked in the medical literature. Headache associated with arterial hypertension is a main concern in emergency department. It is believed that headache may be a symptom attributed to arterial hypertension only if the BP values are very high or rise quickly. Many studies support the hypothesis that migraine patients have an increased risk of developing hypertension, while hypertensive subjects do not seem to have an increased risk of migraine or other types of headache. Conversely many studies found an inverse association. Hypertension has been identified as one of the most important factors of chronic transformation of episodic migraine and increases the cerebrovascular and cardiovascular risk of migraine patients. Migraine and arterial hypertension may share common mechanisms like endothelial dysfunction, deficiency of autonomic cardiovascular regulation and renin angiotensin system involvement. Preventive effects of migraine were described by several antihypertensive agents traditionally beta-blockers, and more recently angiotensin-converting-enzyme inhibitors and angiotensin II receptor blockers.