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Handling Hypertension Headaches

Nina Ghamrawi, MS, RD, CDE
November 12, 2024
November 12, 2024

Hypertension, or high blood pressure, affects millions of people globally, and one of its symptoms is headaches. However, hypertension headaches are not as common as people might think. Here’s a little about what causes a true hypertension headache, and how to recognize and treat it.

How Common Are Hypertension Headaches?

Most people with mild to moderate high blood pressure don’t experience headaches. In fact, only about 10-20% of people with hypertension report regular headaches as a symptom, according to studies. Research shows that headache frequency is not strongly correlated with chronic high blood pressure in the general population . Instead, headaches usually happen when blood pressure rises to extremely high levels.

When Do Blood Pressure Headaches Happen?

Many people think high blood pressure always causes headaches, but research shows they usually happen when blood pressure gets dangerously high like during a hypertensive crisis, or when blood pressure fluctuates a lot.

Critical High Blood Pressure

Headaches from high blood pressure are most likely when it suddenly spikes or stays very high for a long time. These headaches often occur when your systolic BP (top number) is 180 mmHg or higher, or your diastolic BP (bottom number) is 120 mmHg or higher. At these levels, the pressure on your brain's blood vessels can cause a throbbing or pulsing headache.

If you have a severe headache along with these high blood pressure numbers, it’s important to get medical help right away. While these headaches are rare, they can be a sign of a life-threatening problem.

Many Blood Pressure Highs and Lows

Even if your blood pressure isn't in the critical range, sudden changes or fluctuations in blood pressure can trigger headaches. Big jumps in blood pressure, even if they aren’t extremely high, can cause discomfort.

If you're having headaches but your blood pressure isn’t that high or variable, other factors could be the cause. Here's what to consider:

  1. Dehydration, Stress, and Withdrawals
    • Stress: causes tension headaches or migraines;
    • Dehydration: Not drinking enough water can lead to headaches and also raise blood pressure;
    • Medication: Some blood pressure medicines, like diuretics, can cause dehydration, leading to headaches;
    • Caffeine: Too much caffeine, or suddenly cutting back on it, can also cause headaches and affect blood pressure.
  2. Lifestyle Factors: Poor sleep, not exercising, and eating too much salt can make blood pressure go up and lead to headaches. Small changes in your daily habits might help.
  3. Other Health Conditions: Some health problems, like kidney disease or sleep apnea, can cause both high blood pressure and headaches, even if your readings aren't very high. Treating these issues may help with headaches.

How to Fix a Hypertension Headache

To fix the headache in the moment, and to lower the risk, frequency, and severity of the headaches in the future,

  • First, check your blood pressure to make sure the reading is not critical.
  • Lie down: Sit or lie down in a quiet, dark room to reduce sensory stimuli, which can help lower blood pressure and ease headache symptoms. Closing the eyes and deep breathing (box breathing) helps, too.
  • Cold Compress: Place a cold compress on your forehead or neck to help constrict blood vessels and provide relief from the headache.
  • Hydrate: Dehydration (even slight) can make headaches and blood pressure much worse.
  • Avoid caffeine and alcohol: Both can spike blood pressure, and can both dehydrate you. If its done, and the headache is happening after, encourage extra hydration.
  • Reassess nutrient adequacy: Sometimes headache is related to high-sodium, or low protein or carb intake. Review what you ate recently- if high sodium, or lacking in nutrients,
  • Relax blood vessels with food, encourage consuming some high-potassium leafy greens, or other foods to help improve blood oxygenation, like spinach, beets, or beet greens and solve the immediate headache.
  • Recheck blood pressure: Treat your symptoms as above, and recheck after 30 minutes.

Takeaways

Though hypertension headaches are not common in people with mild to moderate high blood pressure, they can occur when blood pressure reaches dangerously high levels, or when blood pressure fluctuates a lot. If you have high blood pressure and experience sudden, intense headaches, it may be a sign of a crisis, and you should contact a healthcare provider immediately. If your blood pressure is not high, the make sure you are adequately hydrated, are eating well, take a rest, and recheck.

Also note that If you can’t find the cause of the headaches,  track Your Symptoms more closely in relation to your blood pressure. If your blood pressure changes a lot  before, during and after the headache, talk to your doctor. Alslo talk to the doctor if your headaches are frequent or severe. They can check for other causes and adjust your treatment plan.

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