High blood pressure is often called a “silent disease” because it may not present symptoms, or the symptoms may be ambiguous. Many people only experience symptoms when their blood pressure levels are dangerously high.
When symptoms do present themselves, it may come in the form of severe headaches. If you think you might have high blood pressure, these headaches should not be ignored.
What Does a High Blood Pressure Headache Feel Like?
A hypertension headache can be especially painful. The most common hypertension headache location is at the top of the head. It may feel like someone is squeezing your head in a vice, or it may feel like a regular migraine.
The pain may be felt in the head, face and neck. It may cause inward or outward pressing sensations. It may also cause pressure in the sinus region. Some people may feel heat in the head or hot flushes throughout the body.
High blood pressure headaches may also cause visual symptoms. Some people may see auras or floater-like images because of the pressure on the eye and the pain behind the eyeballs. Blurred vision and light sensitivity may occur if the retina swells.
Along with the pain, some people will experience dizziness, lightheadedness, disorientation and vertigo. These symptoms are typically experienced when rising from a lying or sitting position.
Some who experience high blood pressure headaches will also experience auditory sensations. Some describe it as the sound of pulsing hammering in the ears, buzzing sounds, high pitched noises or rushing sounds. These sensations may also be felt in the body or the head.
There may also be other symptoms that appear at the same time, such as:
- Nose bleeds
- Irregular heartbeat
- Facial flushing
- Nausea and vomiting
- Restlessness
- Fatigue
- Shortness of breath
In cases of hypertensive encephalopathy, the brain can swell, which can lead to vomiting, drowsiness, seizures, confusion, sleepiness and even coma.
Some people, mostly women of childbearing age and obese women, will experience idiopathic intracranial hypertension. This occurs when high blood pressure in the skull will cause headaches nearly every day. These headaches may be accompanied by obscured vision, nausea, double vision and a throbbing noise in the ears.
High Blood Pressure and Migraines Statistics
It is estimated that about 20% of patients in hypertensive urgency experience headaches. One study, which looked at the relationship between women and migraine and hypertension, found that:
- Participants who had migraine with aura had a 9% increased risk of hypertension
- Participants who had migraine without aura had a 21% increased risk of hypertension
- Participants who had a history of migraine had a 15% increased risk of hypertension
The study had 29,040 female participants. At the start of the study, none of the women had hypertension. In the follow-up 12.2 years later, 15,176 experienced incident hypertension.
While many people do experience headaches when their blood pressure levels are high, there is still no definitive link between hypertension and headaches.
What is a Hypertensive Crisis?
Hypertensive crisis is a term used to describe hypertensive urgency and hypertensive emergency. These two conditions occur when blood pressure levels are so high that it may cause organ damage.
Hypertensive Urgency
When blood pressure spikes to 180/110 or higher but there is no damage to the organs, this is called hypertensive urgency.
Blood pressure medication can be used to bring levels back down safely within a few hours.
Hypertensive Emergency
A hypertensive emergency occurs when blood pressure is so high that it can cause organ damage. Blood pressure levels must be reduced immediately to prevent damage, and this can only be done at the intensive care unit of a hospital.
Organ damage associated with hypertensive emergency may include:
- Stroke
- Heart attack
- Heart failure
- Changes in mental status
- Pulmonary edema (fluid in the lungs)
- Aneurysm
- Cheat pain
- Eclampsia (only occurs during pregnancy)
Hypertensive emergencies are rare. They typically only occur when hypertension is left untreated, if a patient fails to take blood pressure medication, or an over-the-counter medication is taken that exacerbates high blood pressure.
Symptoms of a hypertensive emergency may include:
- Seizure
- Confusion
- Headache or blurred vision
- Edema
- Shortness of breath
- Chest pain
Treating Hypertensive Headaches
If you suspect that your headache is the result of high blood pressure, seek medical attention immediately. Without treatment, there is risk of organ damage and/or unwanted side effects.
Doctors classify hypertension headaches as a hypertensive emergency. Blood pressure levels must be brought down with intravenous (IV) medications, such as labetalol, nicardipine, sodium nitroprusside and nitroglycerine.
It’s important to seek medical attention right away if you believe that your severe headache is associated with high blood pressure. Do not wait for your blood pressure to lower on its own.