High blood pressure, or hypertension, often shows no noticeable symptoms, earning it the nickname “silent killer.” Headaches are generally not a common symptom of everyday high blood pressure. They typically occur only during a hypertensive crisis, when blood pressure is dangerously high.
Common Location and Characteristics
Headaches caused by high blood pressure have distinct characteristics. They are most commonly felt on both sides of the head, rather than in a localized spot. The pain often feels like a dull, pressing sensation across the entire head, or can extend from the back of the head and neck to the front.
These headaches are severe, described as throbbing or pulsating. The pain tends to worsen with physical activity and often strikes in the morning, gradually easing as the day progresses. These headaches are a sign of very high blood pressure, typically when readings are at or above 180/120 mmHg, indicating a hypertensive crisis.
When Headaches Indicate a Hypertensive Crisis
A headache with extremely high blood pressure signals a hypertensive crisis, occurring when readings reach 180/120 mmHg or higher. This severe headache indicates significant pressure on the brain, which can inflame blood vessels and potentially lead to swelling, known as hypertensive encephalopathy. Accompanying symptoms help differentiate a hypertensive headache from more common types. These additional symptoms often include:
Blurred vision or other vision changes
Chest pain
Shortness of breath
Severe anxiety
Dizziness
Nausea or vomiting
Confusion
Numbness or weakness
Nosebleeds
If these symptoms are present with a blood pressure reading of 180/120 mmHg or higher, it signifies a medical emergency requiring immediate medical care.
Differentiating from Other Headache Types
Not all headaches relate to high blood pressure, and self-diagnosis can cause unnecessary anxiety. Common headaches like tension headaches and migraines have different characteristics and are not indicative of elevated blood pressure.
Tension headaches often feel like a dull, aching sensation or pressure, sometimes described as a band around the head, affecting both sides. They are usually mild to moderate and do not commonly present with neurological symptoms like blurred vision or severe sensitivity to light and sound.
Migraines, conversely, are often characterized by severe, throbbing pain that can be one-sided, though they can also occur on both sides. They are frequently accompanied by light sensitivity, sound sensitivity, and nausea or vomiting.
While acute pain, including migraine, can temporarily increase blood pressure, this does not mean the migraine is caused by chronic hypertension. Any new, severe, or persistent headache should prompt consultation with a healthcare professional to determine the underlying cause and ensure appropriate management.