ABSTRACT
We aimed to investigate whether transient increases in blood pressure (BP) are associated with headache, by provoking hypertension in 50 non-hypertensive cephalalgia sufferers (Ce), 50 hypertensive cephalalgia sufferers (HyCe) and 50 healthy subjects (C) with a treadmill stress test. Occurrence of headache among groups did not differ (P = 0.81); however, women developed headache more frequently than men (P < 0.0001). The 35 individuals who developed headache during the test compared with those who did not (regardless of their original group) had higher absolute diastolic BP and higher absolute and relative diastolic BP increase during the test (P < 0.0001). HyCe patients that developed headache had higher diastolic BP than those that did not (P < 0.002). For each group, the absolute/relative mean increases of systolic/diastolic BP did not differ between patients that developed headache and those that did not excepting relative diastolic BP increase in Ce (28% vs. 15%, P = 0.006). The appearance of headache during dynamic exercise is not associated with a history of headache or hypertension. In non-hypertensive cephalalgia sufferers, relative diastolic BP increases of >27% are associated with headache attacks whereas in HyCe sufferers absolute diastolic BP values may be more important.