When Does High Blood Pressure Cause Headaches? It May Be More Rare Than You Think
Key takeaways:
High blood pressure, or hypertension, usually does not cause symptoms. This is especially true if you have mild or moderate hypertension.
Pain — including headache pain — can elevate your blood pressure. And some medical conditions can cause both high blood pressure and headaches.
Rarely, extremely high blood pressure can lead to a headache. This is a medical emergency.
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Headaches are a symptom experienced by most people at some point in their lives. There are many different types of headaches. Some people with high blood pressure (hypertension) do report headache symptoms. But the best evidence hasn’t shown a connection between mild hypertension and headaches.
On the other hand, severely elevated blood pressure can lead to headaches, which is an emergency.
Here, we’ll explain how to know if your headache is a symptom of dangerously high blood pressure — and when to seek care.
Does high blood pressure cause a headache?
Hypertension, often referred to as the silent killer, typically doesn’t cause symptoms. Heart and brain specialists agree that mild or moderate hypertension (less than 180/110 mmHg) does not cause headaches. It’s possible that people with hypertension are more likely to experience headaches. But, so far, studies have not confirmed the link.
Dr. Ryan Gary, a heart specialist, agrees that “mild to moderate hypertension is unlikely to cause headaches, or any symptoms at all.” Still, he says, “it has a serious impact on long-term health and should be treated and routinely monitored.”
Some conditions can cause both headaches and high blood pressure. And pain, including headache pain, can raise blood pressure. So, it would not be surprising to find that your blood pressure is high when you measure it during a headache.
But there are important exceptions to this, including when someone’s blood pressure is dangerously high. This is covered more in the next section.
So then, what is a hypertension headache?
Even though high blood pressure typically does not cause a headache, there are still instances and conditions where it can.
Hypertensive emergency
Severely elevated blood pressure does not always cause symptoms. Rarely, if blood pressure gets very high very quickly, it can cause symptoms. And this is called a hypertensive crisis.
Types of hypertensive crises that can appear with a headache are:
Hypertensive emergency: This condition can happen when systolic blood pressure is more than 180 mmHg or diastolic blood pressure is more than 120 mmHg. Symptoms can include chest pain, trouble breathing, dizziness, confusion, vision changes, and headaches. Headaches come on abruptly and are more severe than typical headaches.
Preeclampsia and eclampsia: These are conditions in pregnancy characterized by swelling, protein in the urine, and high blood pressure. Headaches are usually more severe and longer-lasting than other headaches. Pain may be pulsating, present on both sides of the head, and worse when moving around. Headaches will get better after preeclampsia or eclampsia is treated.
Brain bleeds
Spontaneous brain bleeds can also lead to a headache. Long-standing high blood pressure is a significant risk factor for a brain bleed. Treating hypertension lowers your risk by preventing damage to blood vessels.
The term for bleeding in the brain is a hemorrhagic stroke, and there are two types:
Intracerebral bleed: This is bleeding inside the brain. Usually, a headache is not the only symptom of a brain bleed. People will often have symptoms like those of other types of stroke.
Subarachnoid hemorrhage: This is bleeding into the space surrounding the brain. Bleeding can happen with or without a head injury. A headache could be the first symptom of a subarachnoid hemorrhage. Headaches are usually severe and sudden. Some people report it as the worst headache of their lives.
Other conditions
Some diseases can be associated with both chronic headaches and high blood pressure. Headaches are thought to be related to the underlying problem in these instances. Some of these conditions include:
Obstructive sleep apnea: This is a common condition that causes temporary pauses in breathing during the night. It often causes morning headaches and also contributes to high blood pressure.
Imbalanced hormones: Much more rarely, hypertension and headaches can be caused by conditions that lead to imbalanced hormones in the body. Examples include pheochromocytoma or acromegaly. These disorders tend to also cause other symptoms besides a headache.
Can a stroke cause a headache?
A stroke happens when part of your brain is not getting the oxygen or nutrients it needs. While a headache can be a sign of a stroke, there are usually also other symptoms. Other signs of a stroke are:
Weakness or numbness on one side of the body
Confusion or trouble speaking
Sudden dizziness, loss of balance, or trouble walking
Sudden vision changes
Like with a brain bleed or hypertensive emergency, these headaches are not typical. The pain will also occur suddenly and without warning.
If you or a loved one experiences stroke symptoms, seek care immediately.
What does a blood pressure headache feel like?
Headache symptoms vary from person to person. Not everyone experiences the same symptoms. And there are many types of headache, each with unique characteristics.
Some symptoms that can suggest hypertensive headaches are:
The headache happens or gets worse with high blood pressure (more than 180/120 mmHg).
The headache gets better when the blood pressure improves.
Headaches are often present on both sides of the head and are often described as “pulsating.”
Pain may be brought about by physical activity.
There are no symptoms of altered brain function like those seen in a stroke.
It can be challenging to definitively say that a headache is caused by a hypertensive emergency. But if you have severe symptoms and note that your blood pressure is very high, you should be checked by a healthcare provider. They will look for other causes of headaches. If needed, fast-acting medications will be used to lower your blood pressure.
Can blood pressure medications cause headaches?
Some medications given for blood pressure can cause headaches as a side effect. This is especially the case if your blood pressure gets much lower than you’re used to. These headaches usually go away after your body adjusts to the new medication. But talk to your provider if you have persistent headaches after a medication change.
What should I do if I have high blood pressure and a headache?
For occasional headaches, over-the-counter (OTC) medicines can be used to control pain. Some pain medications, such as NSAIDs, can raise your blood pressure. If you have high blood pressure, acetaminophen (Tylenol) may be a better choice for pain relief.
Talk to your provider about frequent headaches that interfere with your everyday life. They can help you determine what’s causing your headache and make a treatment plan to control your pain.
The bottom line
Mild to moderate hypertension usually doesn’t cause headaches or other symptoms. Headaches can have many causes, and having one doesn’t necessarily mean it’s from blood pressure. Still, controlling your blood pressure is essential to prevent long-term problems. Sudden and severe headaches can be a sign of a medical emergency, like a stroke or a hypertensive crisis. Make sure to urgently see a healthcare provider for non-typical, severe headaches. If you’re having frequent headaches, talk to your provider about finding the cause.
Why trust our experts?
References
American Heart Association. (2022). How high blood pressure can lead to stroke.
American Heart Association. (2023). Why high blood pressure is a “silent killer.”
American Stroke Association. (n.d.). Hemorrhagic stroke.
Assarzadegan, F., et al. (2013). Secondary headaches attributed to arterial hypertension. Iranian Journal of Neurology.
Centers for Disease Control and Prevention. (2021). High blood pressure symptoms and causes.
Centers for Disease Control and Prevention. (2022). Stroke signs and symptoms.
Clinch, C. R. (2001). Evaluation of acute headaches in adults. American Family Physician.
Gus, M., et al. (2001). Behavior of ambulatory blood pressure surrounding episodes of headache in mildly hypertensive patients. Archives of Internal Medicine.
Headache Classification Committee of the International Headache Society. (2018). The International Classification of Headache Disorders, 3rd edition. Cephalalgia.
National Cancer Institute. (2020). Pheochromocytoma.
Whelton, P. K., et al. (2018). 2017 ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A report of the American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. Hypertension.
