Association of Hypertension with Migraine and Tension-Type Headaches: A Cross-Sectional Study

Authors

  • Mehwish Iftikhar Hayatabad Medical Complex, Peshawar, Pakistan
  • Nazir Shah Hayatabad Medical Complex, Peshawar, Pakistan
  • Imran Khan Hayatabad Medical Complex, Peshawar, Pakistan
  • Sheraz Jamal Khan Hayatabad Medical Complex, Peshawar, Pakistan
  • Mian Mufarih Shah Hayatabad Medical Complex, Peshawar, Pakistan
  • Muhammad Bilal Khattak Hayatabad Medical Complex, Peshawar, Pakistan

DOI:

https://doi.org/10.52206/jsmc.2025.15.2.1081

Abstract

Background: Hypertension and headaches frequently coexist in clinical practice as major public health concerns affecting billions globally. Their relationship remains incompletely understood despite decades of research.
Objective: To investigate the prevalence and patterns of hypertension among patients presenting with migraine and tension-type headaches and analyze the strength of association between these specific headache types and hypertension.
Materials and Methods: A cross-sectional study of 788 patients with migraine and tension-type headaches was conducted from January 2024 to July 2024. Blood pressure measurements were performed following standardized guidelines. Headache classifications were made using established international criteria. Statistical analysis included logistic regression modelling and calculation of odds ratios.
Results: Among 788 participants (65.2% female, mean age 42.3±12.7 years), 158 (20.1%) had hypertension, with 90 (11.4%) classified as Stage I and 68 (8.6%) as Stage II. Tension-type headaches showed a higher association with hypertension (22.6%) compared to migraines (13.5%). The odds ratio for hypertension in tension-type headaches was 0.162 (95% CI: 0.092-0.285, p<0.001).
Conclusion: Our findings demonstrate a weak but significant association between tension-type headaches and hypertension, while migraines showed minimal correlation with blood pressure elevation. The relationship varies significantly by gender and age, suggesting the need for individualized clinical approaches.
Keywords: Blood pressure, Hypertension, Migraine, Primary headache disorders, Tension-type headache.

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Additional Files

Published

10-05-2025

How to Cite

1.
Iftikhar M, Shah N, Khan I, Khan SJ, Shah MM, Khattak MB. Association of Hypertension with Migraine and Tension-Type Headaches: A Cross-Sectional Study. J Saidu Med Coll [Internet]. 2025 May 10 [cited 2025 Jun. 12];15(2):274-8. Available from: http://jsmc.pk/index.php/jsmc/article/view/1081