Intended for healthcare professionals

Rapid response to:

Primary Care 10-minute consultation

Headache

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7487.346 (Published 10 February 2005) Cite this as: BMJ 2005;330:346

Rapid Response:

Links between headache and raised BP

As interesting as your article is I believe it risks perpetuating the myth that high BP causes headache. The link is common in that severe pain will elevate BP so that a doctor who believes in a causative link (high BP causes headache) will have that view reinforced when they measure the BP. This situation is analagous and identical to the apparent association between hypertension and nose bleeds. Where hypertension is discovered by accident symptoms occur in those patients who have been informed that they have high blood pressure but not in those who remain ignorant of the fact. Interestingly such symptoms often include headache. Clearly patients with a phaeochromocytoma may have headache and those with accelerated phase hypertension (malignant phase) have raised intra-cranial pressure and may thus have an organic headache. Other features of the history or examination should alert the physician to these disorders but we should emphasise that high blood pressure is not a cause of headache.

Competing interests: None declared

Competing interests: No competing interests

11 February 2005
Paul L Padfield
Consultant Physician/Reader in Medicine
Western General Hospital, Edinburgh, EH4 2XU