Migraine Quiz

High Blood Pressure and Migraine

Is There a Hypertension and Migraine Connection?

Is there a correlation between high blood pressure and migraine? Maybe. There have been studies to suggest that uncontrolled hypertension (high blood pressure) may result in an increase in migraine headache frequency or severity. However, it has also been argued that since both high blood pressure and migraine are commonly occurring conditions, any such relationship is mere coincidence.

Certainly, there can be transient increases in blood pressure during a headache of any type, simply because you are in pain, so it stands to reason that chronic headache sufferers might experience higher overall blood pressure.

Can high blood pressure cause a headache? Usually this is not the case unless blood pressure is extremely high.

A recent retrospective epidemiological study, which means it was looking back in time at previously collected data, actually proposed that maybe hypertension even protects against headache! Other studies, however, seem to suggest that there might be a correlation between hypertension and the transition from episodic to chronic migraine. It has even been suggested that there may be a protective effect for systolic blood pressure (the top number), but a negative effect for diastolic blood pressure (the bottom numner).

The MIRACLES Study, also known as Hypertension and Migraine Comorbidity: Prevalence of Cerebrovascular Events, looked at 2973 patients with hypertension, migraine, or both. About 17% of the subjects had both hypertension and migraine, 40% had migraine only, and 43% had hypertension only. In the subjects with both conditions, migraine onset was older than in the migraine-only group, and onset of hypertension was earlier than in the hypertension-only group. Hypertension was harder to control, and there was often a family history of both migraine and hypertension.

The group with migraine-hypertension comorbidity had a 4.4% risk of stroke, as compared to 3.1% in the hypertension-only group, and 0.7% in those with migraine only. In the 40-49 year-old age group, the rate of previous stroke (or TIA) in the group with both conditions was five times higher than in the hypertension-only group.

It is thus likely that there is a migraine-hypertension link in some migraine patients that may be genetically based. Clearly, more studies are required so that we can understand this connection better.


1. Hagen K, Strovmer LJ, Vatten L, et al. Blood pressure and risk of headache: a prospective study of 22 685 adults in Norway. J Neurol Neurosurg Psychiatry 2002;72:463–6.

2. Friedman, D. Headache and hypertension: refuting the myth. J Neurol Neurosurg Psychiatry 2002;72:431.

3. Bigal ME, Sheftell FD, Rapoport AM, Tepper SJ, Lipton RB. Chronic Daily Headache: Identification of Factors Associated With Induction and Transformation. Headache: The Journal of Head and Face Pain. 2002;42(7):575-581.

4. Agostoni E, Aliprandi A. Migraine and hypertension. Neurol Sci. 2008;29(S1):37-39.

5. Mancia G, Agabiti-Rosei E, Ambrosioni E, et al. Hypertension and migraine comorbidity: Prevalence and risk of cerebrovascular events. Evidence from a large, multicenter, cross-sectional survey in Italy (MIRACLES study). J Hypertens 2011; 29:309–318.

by Christina Peterson

updated June 26, 2011