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    New Relief for the Hypertension Headache

    Headaches are one of the most common complaints of people with high blood pressure. But doctors had thought that blood pressure had to be quite high to cause such pain. Now a new study adds to the growing body of evidence that even mild hypertension causes headaches. Moreover, the headaches subside with hypertension medication.

    Researchers reviewed the data from seven randomized, double-blind,
    placebo-controlled trials on 2,673, middle-aged, primarily white patients
    with mild-to-moderate hypertension (154/101 mm Hg). Dr. Lennart Hansson of
    the University of Uppsala in Sweden, and colleagues report their results in the June 12,
    2000, Archives of Internal Medicine.

    During the studies, which lasted 8 to 12 weeks, 1,987 patients
    received the blood pressure medication irbesartan (Avapro), an angiotensin
    II receptor blocker. The other patients received a placebo. In most of the
    studies, the irbesartan dosage was 75- to 150 milligrams per day.

    Of patients taking irbesartan, 17 percent had headaches, compared
    with 22 percent of those taking the placebo. Even fewer patients may have
    had headaches if they had received larger doses of the drug, the researchers
    note.

    Among the placebo group, 19 percent of the patients with diastolic
    blood pressure of less than 90 mm Hg had headaches, while 27 percent of
    those with blood pressure of 100 mm Hg or greater had them. Younger people (less than fifty years old) were more likely to have headaches than were older individuals. Also, 18
    percent of the men and 29 percent of the women had headaches. The researchers also associated increasing diastolic, but not systolic, blood pressure with new or worsening episodes of headache [why would this be?].

    "The link between headache and hypertension has often been
    attributed to anger, anxiety, or the adverse effects of drug therapy," the
    team notes.

    The study did not examine the effects of other blood pressure medications on headaches, nor did it study the effects of lowering blood pressure without medication.

    According to the authors, the results suggest that "physicians should take patient reports of headache seriously and take steps to aggressively reduce blood pressure, preferably with agents that have superior tolerability profiles, to improve overall quality of life."

    Coauthors of the study have worked for the manufacturers of
    irbesartan, Bristol-Myers Squibb Co., of Princeton, N.J., which funded the
    study. Further studies may be needed, as the reports were based on patients' memories.


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