One of the most dangerous things about hypertension -- or high blood pressure -- is that you may not know you have it. In fact, nearly one-third of people who have high blood pressure don't know it. That’s because high blood pressure doesn’t have any symptoms unless it’s very severe. The best way to know if your blood pressure is high is through regular checkups. You can also monitor blood pressure at home. This is especially important if you have a close relative who has high blood pressure.
Symptoms of Severe High Blood Pressure
If your blood pressure is extremely high, there may be certain symptoms to look out for, including:
Severe headaches
Nosebleed
Fatigue or confusion
Vision problems
Chest pain
Difficulty breathing
Irregular heartbeat
Blood in the urine
Pounding in your chest, neck, or ears
People sometimes feel that other symptoms may be related to high blood pressure, but they may not be:
Dizziness
Nervousness
Sweating
Trouble sleeping
Facial flushing
Blood spots in eyes
When to See a Doctor
If you have any of these symptoms, see a doctor immediately. You could be having a hypertensive crisis that could lead to a heart attack or stroke. You may also have another serious health condition.
Most of the time, high blood pressure doesn’t cause headaches or nosebleeds. But, this can happen in a hypertensive crisis when blood pressure is above 180/120. If your blood pressure is extremely high and you have these symptoms, rest for 5 minutes and check again. If your blood pressure is still unusually high, it’s a medical emergency. Call 911.
It’s important to remember that high blood pressure doesn’t usually have symptoms. So, everyone should get it checked regularly. The American Heart Association recommends that adults with normal blood pressure should get blood pressure checked each year at routine health visits. You may also have it checked at a health resource fair or other locations in your community.
If you have high blood pressure, your doctor might recommend that you monitor it more often at home. At-home monitors may work better than store-based machines. Your doctor will also recommend making lifestyle changes along with medications to lower your blood pressure.
Untreated hypertension can lead to serious diseases, including stroke, heart disease, kidney failure and eye problems.
SOURCES: National Kidney and Urologic Diseases Information Clearinghouse, National Institutes of Health. Heart.org: “What are the Symptoms of High Blood Pressure?” “Monitoring Your Blood Pressure at Home,” “How High Blood Pressure is Diagnosed.” Headache has a variety of types, such as episodic primary headaches [EPH] and chronic primary headache [CPH] in its primary form. There is a positive correlation between these two types of headaches and hypertension [HTN], but in some works this correlation has been reported negatively. Therefore, we planned to study HTN-CPH as well as HTN-EPH correlation in our population. A sample of Rafsanjan population [10,000 individuals] entered the cohort study, as one of the Prospective Epidemiological Research Studies in Iran [PERSIAN]. We compared the frequency of HTN categories in CPH and EPH cases with a normal population. Out of 9933 participants [46.6% males and 53.4% females] about 29% had EPH and 7.5% had CPH. HTN was found in 24.27% of EPH cases and 31.98% of CPH cases. HTN was also found to be associated with EPH and CPH in the crude model. Two Categories of HTN [Long controlled and uncontrolled] were not associated with EPH. On the other hand, CPH showed associations with all of the HTN categories. After included all variables and confounders, EPH and CPH had association with HTN without any considerable changes. There is strong HTN-EPH as well as HTN-CPH correlations in the studied population. Headache is one of the most common neurological disorders in any country. Primary headache disorders has been recognized to be consist of migraine and episodic tension type headache, cluster headache, and chronic daily headache consist of chronic tension type headache, medication over use headache, status migraine and other types, which cause some difficulties for patients. According to the studies it could be affected on nearly 3 billion people life’s every year,,. Based on the findings of some studies, headache disorders ranked third out of 369 conditions in terms of years lived with disability [YLDs] for both sexes. Headache disorders tend to be regular and usually become chronic. About, 10 percent of referrals suffering headache, to clinics of general neurology have been diagnosed with chronic daily headache [CDH], which is usually associated with poor life quality. Many of these patients were underdiagnosed and undertreated. Some studies demonstrated the annual global prevalence of all primary headache disorders about 46%, which 3% was belonged to chronic daily headaches [CDH], . The prevalence of CDH is reported about 2.9% in Asia and almost 4% in Europe, . About 10 to 20 percent of people around the world can experience primary episodic headaches during the busiest periods of their working lives. Women suffer from primary episodic headaches four times more often than men. Chronic primary headache [CPH] is defined as a type of headaches that occurs 15 days a month, for 3 months. This type of headache greatly affect a person’s daily functioning, . The conversion from primary episodic headache to chronic headache is often gradual. These patients have significant impairments in their function and quality of life. Therefore, it is important to identify the factors that contribute to the transformation of primary headaches into chronic daily headaches because each of them has different mechanisms in the occurrence of chronic daily headaches, . However, the major involved mechanisms on conversion from primary headaches into CDH are still unknown. Overuse of analgesic is recognized as the most important factor for such changes. In addition, Hypertension, allergies, diabetes, obesity and hypothyroidism have been reported to be associated with CDH. Association between primary headache and various comorbidities has been shown in some studies, . Some comorbidity is including: neurological, metabolic and cardiovascular diseases, stroke, epilepsy, multiple sclerosis, obesity, diabetes, and hypertension and sleep disorders,,. The association between high blood pressure and a headache was first considered in the early twentieth century. It was stated that a throbbing headache in the early morning was a sign of high blood pressure. In this way, the patients who reported the headache as a chief compliant is illustrated more likely to have moderate or severe hypertension than other major complaints. According to the Third Edition of International Classification of Headache Disorders [ICHD], headache related to arterial hypertension were considered only in patients with systolic blood pressure [SBP] ≥ 180 mm Hg and/or diastolic blood pressure [DBP] 120 mm Hg. For many years, many studies attempted to get an association with hypertension or increased BP in migraine. In that way, some large-scale population-based studies reported a positive association between hypertension and migraine,,. A major risk factor for cardiovascular disease is arterial hypertension [AH], a common disease worldwide. The most generic daily type of primary headache is Tension-type headache [TTH]. Many studies support the hypothesis that TTHs are more susceptible to AH, while people with high BP seem to be at risk for TTH. The relationship between AH and TTH is potentially pathophysiological and clinically significant, but not yet well understood, . The associations between increased BP and headache have been reported repeatedly in the medical literature. Therefore, according to the 3rd edition of International Classification of Headache Disorders [ICHD] and hypertensive patients recording, headache could be considered as the most common symptom in relation to arterial hypertension. Based on population-based epidemiological studies, there is a relatively stable figure for primary headache disorders in various parts of the world. So that, the last year spread of migraine, episodic tension-type headache, chronic daily headache, chronic tension type headache [CTTH] and medication overuse headache [MOH] are reported approximately 10–12%, 35–68%, 4–5%, 2–3%, 1.5–3% respectively. IHS criteria [1994] and the CDH definition by Silberstein et al. have presented the old definition of headache. While there is new definition of headaches according to the current version of ICDH3. Chronic daily headache is replaced by chronic primary headache [CPH] in this new classification. Migraine, episodic TTH and episodic TACs are defined as episodic primary headache and CPH consist of chronic migraine, chronic TTH, and chronic TACs. All of these types of headache take long more than 15 days per month and more than 3 months. In TACs type, it takes long more than 1 year attacks and less than 3 months remission. In a study by Caponnet et al. there was a relation between HTN and primary headache. Previous studies have revealed distinct clinical characteristics for chronic and episodic headaches, including different patterns of response to treatment,,,. This difference may indicate varied underlying biological mechanisms, and distinct relationship of chronic vs. episodic headaches with the risk factors. The questionnaires in Rafsanjan cohort study are designed to provide information on the chronicity or episodic nature of the primary headaches; Therefore, this was an opportunity to compare the relationship between primary chronic headaches and its episodic types with hypertension, and to assess the association of headache and its chronicity with blood pressure. To the best of our knowledge this is the first study of this kind. Considering the importance of following effect on headache, the current study aimed at investigating the association between primary headaches especially episodic versus chronic primary headaches with hypertension based on cohort study of Rafsanjan. The Rafsanjan cohort study [RCS] is a part of the prospective epidemiological research studies in Iran [PERSIAN]. The population consisted of 10,000 residents [aged from 35 to 70] of Rafsanjan, a region in the southeast of Iran. 9933 residents were selected out of this population as the eligible to participate in the study. They were interviewed by validated questionnaires. The study protocol was also designed according to the Persian cohort study and approved by the Ethics Committee of Rafsanjan University of Medical Sciences [Ethical codes: ID: IR.RUMS.REC.1399.134]. We included participants who completed questionnaires information on demography, medical history, habits and laboratory tests. All participants completed validated electronic questionnaires by interview containing information on demography, medical history, smoking, opium use, medical drug use, alcohol consumption, Body mass index [BMI] [kg/m2], family medical history [Diabetes, HTN, cardiovascular disease, stroke, neurological disease, episodic headache, and chronic headache. Moreover, tests were used to measure cholesterol levels, low-density lipoprotein [LDL], high-density lipoprotein [HDL] and triglycerides. Accuracy and precision of all methods were performed in accordance with the relevant guidelines and regulations. Physical activity [PA] derived from standard PA questionnaire totally calculated as metabolic equivalent of task [MET] for 24 h dependent of metabolic equivalent of activities and were also assessed. High blood pressure was defined as 140 mm Hg systolic pressure or 90 mm Hg diastolic pressure or higher in each of these levels. The previous diagnosis of hypertension, with or without treatment by antihypertensive drugs was also considered a hypertension case. As our research was a retrospective study, we had all the data about the participants before entering the study. They had been treated using regular or irregular antihypertensive drugs. The patients’ blood pressure was first measured by Richter brand monitor and suitable size of blood pressure cuff and recorded twice-once in each arm-with a 10-min interval. The mean blood pressure of the right arm was used in the analysis. We also examined duration and control of HTN in participants. Duration of HTN had been already defined as the time interval between self-reported diagnosis of HTN and the date of enrollment. Further, the duration was categorized into ≥ 6 years and Show Sources
Introduction
Methods
Study design and patient selection
Eligibility criteria
Data collection
Chronicity and control of blood pressure