The Hypertensive Headache: a Review


Purpose of Review

The purpose of this review is to provide an overview and update on the common causes of headache attributed to arterial hypertension with a focus on secondary headache disorders. We will also highlight uncommon and recent findings in this area of research.

Recent Findings

There is some controversy in the relationship between chronic hypertension and headache, particularly migraine; recent research suggests that there may be a link, but it is likely complex and multifactorial. Many recent studies and case reports demonstrate that the pathophysiology underlying the onset of headache as it relates to abrupt rises in blood pressure seems to lie at the cellular level and mechanically becomes an issue with disruption of the blood-brain barrier. Although not a formally defined headache entity, carotid revascularization syndrome demonstrates this phenomenon and also has a recent set of proposed criteria that include headache and elevated blood pressure.


This paper reviews the various etiologies of hypertensive headaches, mostly in regard to headache as a secondary symptom of elevated blood pressure. We will also discuss trends of hypertensive headache in pregnancy. Finally, we will touch on controversy that exists in relation to chronic hypertension and its causal relationship to headache as well as the relationship between hypertension and migraine.

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Fig. 1


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Correspondence to Karissa N. Arca.

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Karissa N. Arca and Rashmi B. Halker Singh declare no conflict of interest.

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This article is part of the Topical Collection on Uncommon and/or Unusual Headaches and Syndromes

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Arca, K.N., Halker Singh, R.B. The Hypertensive Headache: a Review. Curr Pain Headache Rep 23, 30 (2019).

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  • Secondary headache
  • Headache
  • Hypertension
  • Blood pressure
  • Arterial
  • Autoregulation