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Can Low Blood Pressure Cause Migraines



Blood Pressure Changes In Patients With Migraine: Evidences Controversial Views And Potential Mechanisms Of Comorbidity

Sherifa Ahmed Hamed *

Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt

*Corresponding Author:
Dr. Sherifa Ahmed Hamed Consultant Neurologist Associate Professor Assiut University Hospital, Department of Neurology and Psychiatry, Floor # 4, Room # 4, Assiut, Egypt P.O.Box 71516 Telephone: +2 088 23749

Visit for more related articles at Journal of Neurology and Neuroscience

The Sensory Amplification Is Hard Wired As Well As Increased During A Migraine And Causes Positive Feedback

 

When you barbeque, you may run into positive feedback. The meat on the grill gets hot, fat drips into the coals, the fat starts to burn, everything gets hotter, more fat … positive feedback !Positive feedback loop as shown in control systems. Input goes through gain G. A portion of it gets fed back with positive sign. If the feedback gain is high, this system can “runaway”, or with a delay in the loop, may break into oscillation.

Hypertension Headache: How To Identify If High Blood Pressure Is The Cause

More than 410,000 Americans died from high blood pressure complications in 2014, attributing to more than 1,100 deaths per day.

High blood pressure can also lead to a condition called hypertension headache. Often occurring in episodes, headaches due to high blood pressure are typically quite severe and occur when blood pressure is 200/100 or higher. Blood pressure reaching these heights can develop into malignant hypertension: a medical emergency.

Hypertension, or high blood pressure, affects about 75 million Americans today—roughly one in three adults. Blood pressure is exerted against the walls of your arteries, which carry blood from your heart to the other parts of the body. Blood pressure is a dynamic measurement, having high and low fluctuations throughout the day. Generally, there is a small range where blood pressure is considered optimal.

Those who have high blood pressure exceeding the normal range are exposed to constant levels of damaging force on their blood vessels. Over time, high blood pressure can put you at risk for heart disease and stroke.

What Are The Types Of Headaches What Type Of Headache Is A Migraine

There are over 150 types of headaches, divided into two categories: primary headaches and secondary headaches. A migraine is a primary headache, meaning that it isn’t caused by a different medical condition. Primary headache disorders are clinical diagnoses, meaning there’s no blood test or imaging study to diagnose it. A secondary headache is a symptom of another health issue.

What Are The Four Stages Or Phases Of A Migraine Whats The Timeline

Can Low Blood Pressure Cause Headaches?

The four stages in chronological order are the prodrome , aura, headache and postdrome. About 30% of people experience symptoms before their headache starts.

The phases are:

  • Prodrome: The first stage lasts a few hours, or it can last days. You may or may not experience it as it may not happen every time. Some know it as the “preheadache” or “premonitory” phase.
  • Aura: The aura phase can last as long as 60 minutes or as little as five. Most people don’t experience an aura, and some have both the aura and the headache at the same time.
  • Headache: About four hours to 72 hours is how long the headache lasts. The word “ache” doesn’t do the pain justice because sometimes it’s mild, but usually, it’s described as drilling, throbbing or you may feel the sensation of an icepick in your head. Typically it starts on one side of your head and then spreads to the other side.
  • Postdrome: The postdrome stage goes on for a day or two. It’s often called a migraine “hangover” and 80% of those who have migraines experience it.
  • It can take about eight to 72 hours to go through the four stages.

    When Should I Seek Immediate Help Or Contact My Healthcare Provider

    • You are experiencing the “worst headache of my life.”
    • You are having neurologic symptoms that you’ve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
    • Your headache comes on suddenly.
    • You have a headache after experiencing a head injury.

    Schedule a visit with your healthcare provider if:

    • The number or severity of your headaches increase or your headache pattern changes.
    • Your medications no longer seem to be working or you’re experiencing new or different side effects.

    How Do Weather Changes Cause Barometric Pressure To Raise Or Drop

    Generally, when the sky is clear and sunny there is higher barometric pressure and when the sky is cloudy and moist then there is low barometric pressure.

    But this isn’t always the case.

    When the sun is out it’s warmer so air is expanding and this causes more pressure.

    But when enough of that heat has caused hot water to evaporate and that hot air to rise high enough to cool down, this causes clouds to form and lowers pressure.

    It’s not as simple as this but this is a general understanding… That’s why we have meteorologists.

    Which Migraine Medications Are Safe To Use While Breastfeeding

    Although it is safest to avoid all medications if breastfeeding, this is not always feasible. Therefore, to avoid unwanted side effects in the breastfeeding infant, medications should be used at the lowest effective dose and for the shortest duration. Generally, the same medications used during pregnancy can be continued after delivery and while breastfeeding. An exception is aspirin which may cause bleeding problems and Reye’s syndrome in the nursing baby and should therefore be avoided. Mothers who must take medications should also consider not breastfeeding.

    Divalproex should not be used in patients with liver or pancreatic disease.

    Research On The Link Between Migraine And High Blood Pressure

    Women are three times more likely than men to have migraine, according to the Migraine Research Foundation, and for this reason, much of the research on the link between hypertension and migraine has been conducted on women.

    According to Dr. Rist, “it’s difficult to untangle the two conditions, and to do so, we need to look at it from so many different angles. It appears that there is a genetic trait linked with both, but some believe it’s a causal relationship,” meaning that either migraine causes high blood pressure or vice versa.

    In a study examining the potential causal relationship, , researchers followed nearly 30,000 women for 12 years. They found that, overall, women who had a history of any type of migraine were more likely to have high blood pressure than women who did not have a history of migraine.

    In addition, some types of migraine appeared to be correlated with higher rates of hypertension than others. Compared with women with no history of migraine, those who had a history of migraine without aura had a 21 percent increased risk of hypertension — twice that of women who had migraine with aura, whose risk was elevated by roughly 10 percent.

    A study looking for a genetic explanation, Nature Communications, identified 12 genes that appeared to have an impact on both blood pressure and susceptibility to migraine.

    The link was strongest between elevated diastolic blood pressure and increased susceptibility to migraine.

    High Blood Pressure Headaches And Other Hypertension Symptoms

    Your blood pressure headache may be exactly what you might guess based on the feelings of pain and pressure in your head. As it feels like, that headache is the result of too much pressure in your head. 

    Other hypertension symptoms are also rare. You might not ever get them or you might get one or more of them only when you have a hypertensive crisis, which can be a medical emergency.

    • Nosebleeds
    • Blood spots in your eyes, or subconjunctival conjunctivitis
    • Reddening of the face, or facial flushing, in the heat, cold, or wind, or after eating spicy foods or drinking hot beverages, or at other times.

    Since these symptoms can indicate a hypertensive crisis, contact your healthcare provider or get medical care immediately if you have them.

    Structural Abnormalities Of The Heart Patent Foramen Ovale

    As noted above, there are structural abnormalities of the heart that occur more frequently in migraineurs, particularly in those who have aura. One of these changes, a patent foramen ovale , is a small hole that connects the right and left upper chambers of the heart, the atria. PFO in the general population is present in about 25% of all people, the vast majority of whom have no symptoms. PFOs may occur in as many as one-third of those with migraine and in 18% of those with aura. There is no recommendation to close PFOs because the benefit in doing so has not been clear.

    What Symptoms Must You Have To Be Diagnosed With A Migraine

    Migraine with aura . This is a headache, plus:

    • Visual symptoms or vision loss.
    • Sensory symptoms .

    Migraine without aura . A common migraine is a headache and:

    • The attacks included pain on one side of your head.
    • You’ve had at least five attacks, each lasting between four and 72 hours.

    Plus, you’ve experienced at least one of the following:

    • Nausea and/or vomiting.
    • Lights bother you and/or you avoid light.
    • Sounds bother you and/or you avoid sounds.

    Which Migraine Medications Are Safe To Use During Pregnancy

    High blood pressure symptoms: Signs of hypertension crisis ...

    Migraine headaches may become less frequent during pregnancy. However, in rare cases migraines may appear for the first time during pregnancy or become worse. Non-drug therapies are considered to be safer during pregnancy, they should be tried first. Non-drug therapies such as relaxation, sleep, massage, ice packs, and lifestyle changes are considered first-line options during pregnancy.

    If drug treatment is required, acetaminophen is usually the treatment of choice. When used appropriately, acetaminophen treatment does not affect the pregnancy or the unborn baby.

    Nonsteroidal anti-inflammatory drugs are considered second-line options and thought to be safest in the second trimester. They should not be used near the time of birth. Opioids are third-line options. Prolonged use of opioids may cause addiction and dependence in mothers and child.

    Triptans are reserved for moderate-to-severe symptoms in women who have failed to adequately respond to other treatments. Sumatriptan is the oldest and most studied triptan in pregnancy. A pregnancy registry for sumatriptan did not find an increased risk of birth defects or miscarriage in 600 patients who were treated with sumatriptan during pregnancy.

    Ergotamines should not be used during pregnancy as they may potentially induce hypertonic uterine contractions and vasospasms/vasoconstrictions which can cause harm to the unborn baby.

    Talking To Your Doctor About Your Blood Pressure Headaches

    If you suspect you have high blood pressure, you need to talk to your doctor to get a formal diagnosis so that you can begin treatment. This is particularly important if you have blood pressure headaches because that can signify a more serious problem. If you are having migraines that also warrants a conversation with your physician because they can help you find a treatment plan.

    Some questions to ask your doctor include:

    • What can I do when I get a blood pressure headache? When should I seek emergency medical treatment?
    • Should I get a home blood pressure monitor? What kind should I get?
    • How often should I check my blood pressure?
    • How high is too high? Too low?
    • What changes should I make to my lifestyle to get better control of my hypertension or migraine?
    • What foods can I eat? What should I avoid?
    • Can I exercise? How much? What are signs that I should stop?
    • What kind of medication are you prescribing to me?
    • Will this medication help my headache or make it worse?

    Amazing Barometric Pressure Migraines And Headaches Remedy

    Barometric pressure headaches are a huge problem because they can be so unpredictable and strike at the worst times.

    The graph below shows major triggers leading to migraines among U.S. patients as of 2016:

    Changes in weather and barometric pressure are a huge problem and go together.

    In this article we will understand what causes barometric pressure headaches and what we can do about it.

    Does High Blood Pressure Cause Headaches Or Other Symptoms

    Q.My friend insists that she can feel when she has high blood pressure, because her face flushes and she gets a headache. Is this possible?

    A. In almost all instances people cannot feel high blood pressure and are unaware that they have it. This is why it is often referred to as a silent killer.

    It is usually only when a person is in the midst of what is known as a hypertensive crisis — a period of extremely high blood pressure with a reading of 180/120 millimeters of mercury or higher — that she or he will experience symptoms, such as a headache. This is considered a medical crisis, and if it occurs, you should call 911 and get emergency help.

    However, even in these instances, high blood pressure can’t be diagnosed based on symptoms alone. The only way to truly tell if you have elevated blood pressure is to take a reading with a blood pressure cuff.

    If your friend is experiencing frequent headaches and other symptoms she’s attributing to high blood pressure, it might be wise for her to visit her doctor to make sure another condition isn’t causing the problem. If she does have uncontrolled high blood pressure, she should also be certain to work with her doctor to manage her condition. Unchecked, high blood pressure can lead to numerous complications, including damage to your arteries, brain, heart, and kidneys.

    — by Hope Ricciotti, M.D., and Toni Golen, M.D.Editors in Chief, Harvard Women’s Health Watch

    Relief From Dizziness And Headaches At Fastmed Urgent Care

    If you suffer from frequent or severe dizziness and headaches, you should consult a medical professional to find the cause of these symptoms and get the relief you need.

    The medical professionals at FastMed Urgent Care will provide the caring, fast, and affordable care you need when your dizziness and headaches become a concern. Our goal is to get you seen and back out on your way in under an hour. We also have on-site diagnostic equipment, so we will hopefully get to the bottom of your symptoms and find the treatment you need.

    Our convenient extended weekday hours make it easy to stop by after work, and our weekend hours provide you with an affordable option when primary care physician offices may be closed.

    Like us on Facebook to learn more about FastMed Urgent Care in your community, and contact us to learn more about how we can help relieve your dizziness and headaches!

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    Migraine Treatment When Cardiovascular Disease Is Present

    Unfortunately, any migraine treatment that decreases the width of a blood vessel, even very temporarily, cannot be used in those who have or might have cardiovascular disease. In those who are at increased risk by uncontrolled blood pressure, high cholesterol, or several risk factors, such as smoking, diabetes, obesity, and heredity, these risk factors need to be treated and consideration be given to cardiac testing, such as exercise treadmill or nuclear stress test. It is estimated that triptans , as well as DHE, can narrow heart blood vessels by 18%. While this is a minor narrowing for a person with normal heart vessels, in those with cholesterol build up, it can become significant.

    All non-steroidal anti-inflammatory drugs , such as ibuprofen, diclofenac, and naproxen, now carry a black box label from the US Food and Drug Administration because of their association with increased risk of heart attack. NSAIDs do vary in the amount of risk to the heart, with naproxen the safest. Other NSAIDs vary in their heart risk, mostly seen in those who use them frequently. Using NSAIDs not more than 2 days a week is generally safe in most individuals who have never had a heart attack. Other acute, as-needed medications that may help dial down the migraine pain without causing blood vessel narrowing include metoclopramide, prochloperazine, diphenhydramine, baclofen, acetaminophen, and gabapentin. Trigger point injections and nerve blocks may also be used.

    Deborah Tepper, MD

    Migraine Causes Far More Vertigo Than Any Other Condition

    Nearly 13% of the adult population of the United States has migraine . About 1/3 of persons with migraine headaches report dizziness . Headache and dizziness often appear independently . Strict criteria suggest that about 1.5% of the German population has migraine associated dizziness . As strictness can cause underestimation errors, in our judgment, a reasonable estimate is that about 3% of the adult population of the United states has migraine associated dizziness.

    Barometric Pressure And Migraines: What You Need To Know

    Migraine Relief Center

      Long before meteorologists began making weather forecasts, migraineurs were likely able to predict coming storms with unhappy accuracy. This is because barometric pressure makes itself felt well ahead of time, foretelling the arrival of thunderstorms and other weather patterns that have an effect on migraine patients.

      Brain Tumors And Migraine Causing Dizziness In Migraine

      Can Low Blood Pressure Cause Headaches? Natural Remedies

      Occasionally of course, patients with migraine will have other disorders such as brain tumors. Go HERE to see an example of this rare situation. The association works like this: Migraine, per se, does not cause brain tumors, but the headaches of brain tumors can be mistaken for migraine, or occur in the same person that has migraine.

      What Does A Headache Feel Like With High Blood Pressure

      According to the American Heart Association , a headache can be a sign that a person is experiencing a hypertensive crisis, meaning blood pressure reaches 180/120 millimeters of mercury or higher, which is a medical emergency if it does not quickly lower. Anyone who experiences blood pressure this high and has a headache or nosebleed should see a doctor immediately, the AHA notes.

      When systolic blood pressure is greater than 180, headache can occur along with confusion and visual changes, adds Monteith.

      “Any secondary warning signs could be a sign of something much worse,” she says. These signs include vision loss, weakness, vertigo, trouble with balance, or change in speech. Pregnant women should be keenly aware of any warning sign that may indicate high blood pressure, including migraine.

      “Headaches and severe hypertension can sometimes be signs of a stroke, so getting to the emergency room immediately, especially if neurological symptoms develop, is critical,” says Monteith.

      Neurotransmitter Changes Causing Dizziness In Migraine

      Persons with migraine have fluctuating levels of serotonin, and medications that manipulate serotonin, such as some of the antidepressants, are very powerful agents to control migraine. Dizziness is a moderately common side effect of antidepressants in general, including many of those that manipulate serotonin.

      If serotonin mechanisms were important in migraine associated vertigo, one would anticipate that medications that manipulate serotonin such as , would be effective treatment of migraineous vertigo. Furman et al reported that one triptan , reduces motion sickness in migraineurs. In an uncontrolled study, Cassano reported about 50% response to a triptan as well. While we have been in clinical practice for many years, seeing many migraine patients/week, we have rarely encountered this situation. Still, our take on this idea, as of 2020, is that it is worth trying, with low-risk triptans ..

      We have, however, encountered patients who can treat their photophobia/phonophobia with nonsteroidals. This would be in favor of the general idea that one can treat for migraine pain, and sometimes alleviate other symptoms.

      Cerebellar Disturbances Causing Dizziness In Migraine

      The cerebellum in part, controls balance. Persons with migraine often exhibit unsteadiness with a cerebellar pattern. Persons with severe migraine may develop profound ataxia, sometimes requiring use of a walker or cane, without any signs of inner ear disturbances. Cerebellar findings are sometimes reported in migraine , although this is of very little importance as focal neurological deficits could certainly occur in any disorder that can cause stroke. In our otoneurology clinical practice, we occasionally see gaze and rebound nystagmus in individuals with migraine, but this is by no means a universal finding.

      Inner ear testing in migraine, is generally normal. In fact, rotatory chair testing usually shows that inner ear function is excellent. The cerebellum has within it circuitry that could cause nystagmus.

      In other words, in our opinion, a common mechanism for migraineous dizziness is changes in cerebellar metabolism.

      Can Barometric Pressure Cause Migraines And Headaches

      Barometric pressure is a completely normal event and we have experienced it for millions of years throughout our evolution.

      It’s even reasonable to assume that knowing when the weather was changing would have provided an additional adaptation to survival because we would then have some time to prepare before any storms hit.

      It’s usually the case that barometric pressure will change 5-6 hours before a storm comes but some very sensitive migraine and headache sufferers can feel it up to a day or two prior.

      As the barometric pressure drops and the pressure in the atmosphere around us becomes low, our body has to adapt.

      This causes many different changes in our bodies including changing the pressure in our ears and sinuses.

      If our ears or sinuses have mucus or blockages, this makes the problem much worse because the air in them will try to expand, pressing on nerves.

      This means we need to choose cleaner diets that are less mucus forming.

      According to mother nature network there are also changes in blood pressure, blood sugar and event joint pain when the barometric pressure changes.

      It’s completely reasonable to suspect that if blood pressure, blood sugar and joint pain are all adversely affected, then the body is going through big changes during lowering or heightening barometric pressure.

      We know the migraine brain is one that does not like change and these are not small changes if they can affect these factors.

      Treatment For Medically Refractory Migraine Headaches

      In cases where no other preventive or acute treatments have provided significant relief from migraine headaches, an affected person may be recommended to explore neuromodulation therapies. As described by the International Neuromodulation Society, these are a recent development in the treatment of migraine headaches, which involve the use of technological devices which alter, or modulate, a person’s nerve activity by delivering targeted electrical or pharmaceutical agents to a specific area.

      In treating migraine headaches, the device is used to supply the electrical or pharmaceutical agents to a specific area of the head or neck, for a particular amount of time. These factors will vary according to which particular treatment is used.

      For more information about neuromodulation therapies in the treatment of medically refractory migraine headaches and other headache disorders, see this fact-sheet from the International Neuromodulation Society.

      What Are The Different Types Of Migraine Medications

      Migraine medications fall into two major categories.

      • The first contains drugs that abort or stop migraines from progressing once they begin. The earlier these drugs are used in a migraine attack, the better they work.
      • The second category contains drugs that prevent migraines from happening.

      Over-the-counter migraine medications used to address pain include analgesics, NSAIDS, and caffeine, including:

      • Naproxen
      • Ibuprofen
      • Acetaminophen
      • Or combinations of these

      One drawback to using analgesics and NSAIDs is that taking them daily can make headaches worse due to medication overuse.

      Prescription drugs used to provide relief from pain include

      • NSAIDs and

      Like over-the-counter medications, prescription drugs often come in combinations.

      • A barbiturate called butalbital is often used in combination with acetaminophen, and
      • caffeine with or without codeine .

      Barbiturates are a sedative and may be useful to help people sleep off the pain.

      While analgesics, NSAIDs, and narcotics relieve pain, they don’t address the underlying physiology — primarily the dilation of blood vessels in the brain. Two classes of migraine drugs are:

      • ergotamines and 
      • triptans.

      Ergot alkaloids — such as ergotamine tartrate and dihydroergotamine mesylate — are potent drugs that constrict blood vessels. Because nausea is a possible side effect of these migraine drugs, some people take ergotamines in combination with other drugs to prevent nausea.


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