Abstract
Objective: The aim of the present study was to assess the prevalence of hypertension in adult patients presenting with headache.
Place and duration of study: Private clinic of the author from January 2002 to December 2003.
Patients and Methods: A total of 972 patients with headache were examined and blood pressure was measured by standard mercury sphygmomanometer in all the patients. The patients were labeled as hypertensive and normotensive according to JNC-7 guidelines.Based on the history headache was diagnosed according to International Headache Society guidelines and was clinically divided as migrainous and (non- migrainous) tension headache.
Results: Of the 972 patients, 261 patients were clinically diagnosed as having migraine and 711 patients as having (non-migrainous) tension headache. The total number of hypertensive patients were 195 (20.06%) and the total number of normotensive patients were 777 (79.94%). Hypertension was also graded accordingly as Stage-I and Stage-II. There were 112(11.52%) patients with stage-I hypertension and 83(8.53%) patients with stage-II hypertension. Of the patients clinically diagnosed as migraine only 11(1.13%) patients had Stage-I hypertension while 4(0.41%) had Stage-II hypertension. Of the patients diagnosed as (non-migrainous) tension headaches had Stage-I hypertension in 101 patients(10.39%) while Stage-II hypertension in 79(8.13) patients. Two hundred and forty six(25.31%) Migraineur and 531 (54.63%) non-migraneurs had normal blood pressure. Five hundred and thirty one patients had no hypertension and were labeled as normal.The total Odds ratio for hypertension in headache was 0.1799( 95% CI Range: 0.104-0.3112). For hypertension the sensitivity of (non-migrainous) tension headache is 92% and a specificity of 32%. This is only 68% and 7% for migrainous headache.
Conclusion: A large number of patients with headache are normotensive and thus headache should not be considered as a very important symptom of hypertension as the myth prevails in our society

Key words: Headache, hypertension.