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Hypertension and Migraine: Time to Revisit the Evidence

  • Chronic Daily Headache (SJ Wang, Section Editor)
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Abstract

Purpose of Review

It was reported that migraine was associated with increased vascular risks, and the association between high blood pressure (BP) and migraine was believed by some to be the missing link. The current review focused on the associations between migraine and hypertension and BP per se, and evidence on the directionality of the associations was also reviewed.

Recent Findings

In cross-sectional studies, the findings regarding whether migraine was associated with hypertension were inconsistent, and positive, neutral, or even inverse associations were reported. When individual BP parameters were examined separately, migraine was associated with higher diastolic BPs, and perhaps lower pulse pressures, although the associations with systolic BPs were incongruent. When studies mainly recruiting elderly patients are excluded, it appeared that studies reporting a positive association between migraine and high BPs, particularly high diastolic BPs, outnumbered those with an inverse or neutral association. In longitudinal studies, there was evidence that migraine patients were at increased risks of developing hypertension at follow-up. However, studies examining whether high BP could predict new-onset migraine yielded conflicting results.

Summary

The association between migraine and hypertension is still a controversial issue, and a firm conclusion is precluded by the heterogeneities in methodologies and study populations. Migraine patients are at increased risk of developing hypertension. However, whether hypertension predicts migraine remains inconclusive. Further studies are needed to clarify the complicated association between BP and migraine.

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Authors and Affiliations

  1. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei, 11217, Taiwan

    Yen-Feng Wang & Shuu-Jiun Wang

  2. College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Yen-Feng Wang & Shuu-Jiun Wang

  3. Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Yen-Feng Wang & Shuu-Jiun Wang

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Correspondence to Yen-Feng Wang.

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Conflict of Interest

This review was sponsored in part by the Taiwan Ministry of Science and Technology [MOST 109-2314-B-075-054, MOST 108-2321-B-010-014-MY2, 108-2321-B-010 001, and 108-2314-B-010-023-MY3] and the Taipei Veterans General Hospital [VGH 108-C-092 and VGH 109-C-096, VGH-109-D52-002-MY3-1, and VGH-109-D52-002-MY3-2].

YFW has received honoraria as a speaker from the Taiwan branches of Allergan/AbbVie, Eli Lilly, Novartis, Pfizer, Sanofi, and UCB. He has received research grants from the Taiwan Ministry of Science and Technology and the Taipei Veterans General Hospital. SJW has served on the advisory boards of Daiichi-Sankyo, Eli Lilly, and Novartis, has received honoraria as a moderator from Allergan/AbbVie, Pfizer, Eli Lilly, Biogen, and Eisai, and has been the PI in trials sponsored by Eli Lilly, Novartis, and Allergan/AbbVie. He has received research grants from the Taiwan Minister of Technology and Science (MOST), Brain Research Center, National Yang-Ming University from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan, Taipei Veterans General Hospital, Taiwan Headache Society, and Taiwan branches of Eli Lilly, Novartis, and Pfizer.

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Wang, YF., Wang, SJ. Hypertension and Migraine: Time to Revisit the Evidence. Curr Pain Headache Rep 25, 58 (2021). https://doi.org/10.1007/s11916-021-00976-x

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