Hypertension Headaches

There are several types of headaches caused by hypertension. Hypertension, also called high blood pressure, occurs when the force of the blood flow inside the blood vessels is higher than normal. In most cases, high blood pressure does not cause headaches. However, when it does, it is usually a sign of a serious health condition.1,2

What are hypertension headaches?

The pain of these headaches is usually felt on both sides of the head and pulses or throbs. The pain goes away when the person’s blood pressure goes down. High blood pressure in these cases means:1

  • A systolic number of 180 mmHg or higher (Upper number in a blood pressure reading)
  • A diastolic number of 120 mmHg or higher (Lower number in a blood pressure reading)

Lower levels of high blood pressure (140 to 159/90 to 99 mmHg) do not seem to cause headaches. Mid-range high blood pressure (160 to 179/100 to 109 mmHg) may lead to headaches but doctors are not completely sure.1

Hypertension headaches are known as secondary headaches. This means that the headache is caused by an underlying health condition. A severe headache may be a sign of dangerously high blood pressure.

Pre-eclampsia and eclampsia

Pre-eclampsia is a condition in which blood pressure rises to a dangerous level (over 140/90 mmHg) when a woman is pregnant. Symptoms include weight gain, swelling (edema), vomiting, and high blood pressure. Severe headache is caused by the high blood pressure, along with blurred vision, blind spots, confusion, and fainting.1,3

If the woman’s blood pressure is not controlled, the condition progresses to eclampsia, and seizures and coma may occur. Pre-eclampsia is treated with magnesium sulfate.3

Headache caused by an adrenal tumor

The adrenal glands sit on top of the kidneys and make many of the hormones the body needs to work. Sometimes headaches are caused by an adrenal tumor (pheochromocytoma). The tumor can cause quick increases in blood pressure that in turn cause headaches. Symptoms of this type of headache are:3

  • Head pain that lasts 15 minutes to 1 hour
  • Severe pulsing or constant pain
  • Come with sweating, palpitations, anxiety, and paleness

The headache goes away when blood pressure lowers or the tumor is removed.

Hypertensive encephalopathy

Sometimes an infection or other disease will cause blood pressure to rise dramatically. This in turn leads to problems with how the brain works or hypertensive encephalopathy. Hypertensive encephalopathy may result in:3

Hypertensive crisis without encephalopathy

Hypertensive crisis describes a quick and dramatic increase in blood pressure of over 180/120 mmHg. This is an emergency situation that can cause organ damage if not corrected quickly. Symptoms of a hypertensive crisis include:3

  • Severe headache
  • Fainting
  • Chest pain
  • Nose bleed
  • Shortness of breath

This condition is more common in people who already have some level of high blood pressure. It happens most often in people between 40 and 50 years old, men, and people who are Black. A hypertensive crisis may be caused by kidney disease, Cushing’s disease, cocaine or PCP use, and misuse of certain prescription drugs. This headache goes away when blood pressure drops to more normal levels.3

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Written by: Jessica Johns Pool | Last reviewed: October 2020