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January 11, 2023
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Migraine, severe headache history associated with hypertension risk

Fact checked byRichard Smith
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U.S. adults who reported a history of migraine or severe headache were 25% more likely to develop hypertension compared with those with no migraine history, with a higher risk for women vs. men, researchers reported.

“Elevated blood pressure is more frequently detected in patients with headaches during admission to the emergency department than in those without headaches,” Jing Zhang, MBBS, PhD, of the department of cardiology at the First Affiliated Hospital of Nanjing Medical University, China, and colleagues wrote in the study background. “Migraineurs also tend to have a higher risk of cardio-cerebrovascular diseases. In addition, several BP-lowering drugs, including beta-blockers, ACE inhibitors and angiotensin II receptor blockers, have been demonstrated to be effective in the prophylactic treatment of migraine. Collectively, these findings provide a rationale for elucidating the association between migraine and hypertension.”

Graphical depiction of data presented in article
U.S. adults who reported a history of migraine or severe headache were 25% more likely to develop hypertension vs. those with no migraine history, with a higher risk for women vs. men.
Data were derived from Zhang J, et al. Nutr Metab Cardiovasc Dis. 2022;doi:10.1016/j.numecd.2022.11.014.

In a cross-sectional study, Zhang and colleagues analyzed data from 5,716 adults who completed the National Health and Nutrition Examination Survey between 1999 and 2004. Self-reported migraine was identified from yes/no responses to the question, “Has a doctor ever said that you suffer or have suffered from migraine or severe headache?” Researchers assessed the association between migraines, severe headaches and hypertension.

Within the cohort, 19.8% of respondents reported migraine or severe headaches. Participants with migraine were predominantly younger women and had a higher BMI, lower education level and lower dietary intake of potassium and calcium compared with participants without migraine. Those reporting migraines also had lower serum levels of total cholesterol, creatinine and hemoglobin, as well as a higher estimated glomerular filtration rate (P for all < .05).

After adjustment for potential confounders, a history of migraine or severe headaches was positively associated with hypertension (OR = 1.25; 95% CI, 1.03-1.53).

In subgroup analyses, positive associations between migraine or severe headache and hypertension were detected in women (OR = 1.39; 95% CI, 1.07-1.82), those with a lower BMI, defined as 25 kg/m2 or less (OR = 1.51; 95% CI, 1.09-2.08) and those without diabetes (OR = 1.27; 95% CI, 1.05-1.55). However, there was no statistically significant association among migraine, severe headache and hypertension across all subgroup characteristics.

The researchers noted that the association of migraine with hypertension may differ between patients with or without aura and between patients with different headache frequencies.

“Further prospective and mechanistic studies are needed to elucidate the causality of these associations,” the researchers wrote.