If you have a headache and notice a high blood pressure reading, it's natural to worry about a high blood pressure headache. Most of the time, though, headaches aren't caused by mild or moderate hypertension. Still, very high readings or certain symptoms do need quick attention. This guide will help you tell the difference, check your blood pressure correctly, and decide whether self-care, virtual care, or urgent help is the right next step.
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Does high blood pressure cause headaches? What we know
Usually no. Hypertension is “silent.” Most people with high blood pressure don't experience headaches as a direct symptom. In fact, hypertension is often called a “silent killer” because it typically has no noticeable symptoms until it causes serious complications.
However, pain, stress, or caffeine can raise your blood pressure temporarily. When you're in pain or stressed, your body releases hormones that can cause a temporary spike in blood pressure. Similarly, caffeine can cause a short-term increase. These temporary elevations usually return to normal once the trigger is removed.
Headaches become more concerning when your blood pressure is very high or rises quickly. A hypertensive crisis occurs when your blood pressure reaches or exceeds 180/120 mmHg. At these levels, headaches can occur because the extremely high pressure can cause changes in blood flow to the brain.
It's important to remember that one high reading isn't a diagnosis. Blood pressure fluctuates throughout the day based on activity, stress, medications, and other factors. A single elevated reading doesn't necessarily mean you have hypertension or that your headache is caused by high blood pressure.
What a blood pressure headache might feel like
There's no dead giveaway that distinguishes a blood pressure headache from other types. When headaches do occur with very high blood pressure, they often feel pulsing or throbbing on both sides of the head. Some people describe pressure at the back of the head or behind the eyes.
“High blood pressure headaches don't have a unique signature,” says Marjory Bravard, MD, co-founder of Gen Med. “They can affect any part of the head and may feel similar to tension headaches or migraines. What makes them concerning is the context—very high blood pressure readings along with the headache.”
The headache can affect any part of the head and may be accompanied by other symptoms like dizziness, vision changes, or confusion, especially during a hypertensive crisis.
High blood pressure and headaches: What else could be going on?
Many conditions can cause headaches, and they often overlap with high blood pressure without being directly caused by it. Here are some common culprits:
Tension headaches: These are the most common type of headache and can feel like a band of pressure around your head. Stress, which can also raise blood pressure temporarily, is a common trigger.
Migraine: Migraines can cause severe, throbbing pain and may be triggered by various factors including stress, certain foods, or hormonal changes. Some people notice their blood pressure increases during a migraine attack.
Dehydration or missed meals: Not drinking enough water or skipping meals can cause headaches and may also affect blood pressure readings.
Caffeine issues: Too much caffeine can cause headaches, and withdrawal from caffeine can also trigger them. Caffeine can also temporarily raise blood pressure.
Poor sleep: Lack of sleep or poor sleep quality can contribute to both headaches and elevated blood pressure.
Medication or supplement effects: Some medications, including certain blood pressure medications, can cause headaches as a side effect. Over-the-counter pain relievers, when used too frequently, can also cause rebound headaches.
Sinus pressure or infection: Sinus headaches can cause pressure and pain in the forehead, cheeks, or around the eyes, which may coincide with elevated blood pressure readings.
Check your blood pressure correctly
Getting an accurate blood pressure reading is crucial for understanding whether your headache might be related to hypertension. Here's how to check your blood pressure correctly:
Avoid spiking activities 30 minutes before: Don't exercise, smoke, drink caffeine, or eat a large meal within 30 minutes of taking your blood pressure. These activities can temporarily raise your readings.
Rest for 5 minutes: Sit quietly for at least 5 minutes before taking your reading. This allows your body to return to a resting state.
Sit properly: Sit with your back supported, feet flat on the floor, and your arm supported at heart level. Don't cross your legs.
Use the correct cuff size: A cuff that's too small or too large will give inaccurate readings. Most home monitors come with standard-sized cuffs, but if your arm is larger or smaller than average, you may need a different size.
Stay still and silent: Don't talk or move during the reading. Movement can affect the accuracy of the measurement.
Take two readings 1 minute apart: Take two readings about 1 minute apart and average them for the most accurate result. This helps account for any variability.
Avoid rapid-fire rechecks: Don't immediately take multiple readings in a row. If you're concerned about a reading, wait at least 5 minutes before checking again.
How to get rid of high blood pressure headache instantly: safer immediate steps
There's no guaranteed instant fix for a high blood pressure headache. However, there are safer immediate steps you can take:
Address the blood pressure itself: If your blood pressure is very high (approaching or above 180/120), this needs medical attention. Don't try to treat it yourself with extra medication.
“Take your medications exactly as prescribed,” advises Dr. Bravard. “Don't double-dose or skip doses. If your blood pressure is consistently high, work with your provider to adjust your medication regimen safely.”
Recheck your blood pressure correctly: Make sure you're following proper technique. An inaccurate reading might be causing unnecessary worry.
Pay attention to how you feel: Note any other symptoms like vision changes, confusion, chest pain, or shortness of breath. These could indicate a more serious situation requiring immediate medical attention.
Don't double-dose: Never take extra blood pressure medication without your provider's guidance. This can cause your blood pressure to drop too low, which can be dangerous.
Reduce triggers: If stress or pain is contributing to both your headache and elevated blood pressure, try relaxation techniques like deep breathing, meditation, or gentle stretching.
Use basic headache relief: If your blood pressure isn't dangerously high, you can try standard headache treatments like rest in a dark room, a cool compress, or over-the-counter pain relievers (if your provider has approved them).
Treat very high readings with symptoms as urgent: If your blood pressure is 180/120 or higher and you have a headache along with other symptoms like chest pain, shortness of breath, vision changes, or confusion, seek immediate medical care.
Diagnosis and testing: how clinicians evaluate this
When you see a healthcare provider about headaches and high blood pressure, they'll evaluate several factors:
Symptom story: Your provider will ask detailed questions about your headaches—when they started, how often they occur, what they feel like, what triggers them, and what makes them better or worse.
Blood pressure patterns over time: A single high reading doesn't diagnose hypertension. Your provider will look at multiple readings over time to see if there's a consistent pattern of elevated blood pressure.
Medication review: Your provider will review all medications and supplements you're taking, as some can cause headaches or affect blood pressure.
Risk factors: Factors like family history, age, weight, diet, exercise habits, and other medical conditions help your provider assess your overall cardiovascular risk.
Targeted testing when needed: Depending on your symptoms and risk factors, your provider may order tests like blood work, an electrocardiogram (EKG), or imaging studies to rule out other causes of headaches or to assess cardiovascular health.
Treatment options: what helps (short-term and long-term)
Treatment depends on whether you're dealing with an emergency situation or managing ongoing hypertension:
Rule out emergency: The first priority is ensuring you're not experiencing a hypertensive crisis or other medical emergency that requires immediate treatment.
If high but not dangerous: If your blood pressure is elevated but not in the crisis range, your provider may adjust your medications, add new medications, or change your treatment plan.
Support the headache itself: Your provider may recommend specific treatments for headache relief, which might include medications, lifestyle changes, or referral to a headache specialist if needed.
Habits that steady blood pressure over time: Long-term management focuses on lifestyle factors:
- Regular physical activity
- A heart-healthy diet (like the DASH diet)
- Maintaining a healthy weight
- Limiting sodium intake
- Managing stress
- Limiting alcohol
- Getting adequate sleep
Home monitoring routine: Your provider may recommend regular home blood pressure monitoring to track your progress and ensure your treatment is working.
Plan for next spike: Work with your provider to create a plan for what to do if your blood pressure spikes again, including when to seek immediate care versus when to schedule a follow-up appointment.
Working with a healthcare provider
Effective management of high blood pressure and headaches requires a partnership with your healthcare provider:
Bring real data: Keep a log of your blood pressure readings, noting the time of day, any activities beforehand, and any symptoms you experienced. This helps your provider see patterns and make informed decisions.
List medications honestly: Bring a complete list of all medications and supplements you're taking, including dosages. Don't forget over-the-counter medications, as some can affect blood pressure or interact with prescription medications.
Explain how it feels: Describe your headaches in detail—when they occur, what they feel like, how long they last, and what seems to trigger or relieve them. This information helps your provider determine if your headaches are related to blood pressure or something else.
Virtual care at Gen Med: Gen Med offers convenient virtual care options for managing high blood pressure and headaches. Through telehealth appointments, you can discuss your symptoms, review your blood pressure readings, adjust medications, and develop a treatment plan—all from the comfort of your home.
Follow-up monitoring: Regular follow-up appointments help ensure your treatment plan is working and allows for adjustments as needed. Your provider may recommend checking in every few weeks initially, then less frequently once your blood pressure is well-controlled.
Build a “what if” plan: Work with your provider to create a clear plan for different scenarios—what to do if your blood pressure spikes, when to seek immediate care, and when to schedule a routine follow-up.
When to seek care (red flags)
Some situations require immediate medical attention. Seek emergency care if you experience:
Blood pressure around 180/120+ with symptoms: If your blood pressure reaches or exceeds 180/120 mmHg and you have symptoms like headache, chest pain, shortness of breath, vision changes, or confusion, this is a hypertensive emergency requiring immediate treatment.
Sudden worst headache of your life: A sudden, severe headache that feels different from any headache you've had before could indicate a serious condition like a brain aneurysm or stroke, especially if accompanied by high blood pressure.
New neurologic symptoms: Symptoms like vision changes, confusion, difficulty speaking, weakness or numbness on one side of your body, or loss of balance require immediate evaluation, as they could indicate a stroke or other serious condition.
Severe headache with fever, stiff neck, or vomiting: These symptoms could indicate meningitis or another serious infection requiring urgent medical care.
Pregnant or postpartum with headache and high readings: High blood pressure during pregnancy (preeclampsia) or in the postpartum period can be dangerous and requires immediate medical attention.
Rapidly worsening symptoms: If your symptoms are getting worse quickly, don't wait—seek immediate care.
Key takeaways
- Most headaches aren't caused by mild or moderate high blood pressure. Hypertension is typically “silent” and doesn't cause noticeable symptoms.
- Very high blood pressure (approaching or above 180/120) is different and can cause headaches, especially when it rises quickly. This requires immediate medical attention.
- Checking your blood pressure correctly is essential for accurate readings. Follow proper technique—rest for 5 minutes, sit properly, use the correct cuff size, and take two readings 1 minute apart.
- Headaches and high blood pressure often overlap without a direct cause-and-effect relationship. Many factors can cause both symptoms independently.
- There's no instant fix for high blood pressure headaches. Focus on addressing the underlying blood pressure issue safely, following your provider's guidance.
- Virtual care at Gen Med can help you manage high blood pressure and headaches, develop a treatment plan, and determine when you need in-person or emergency care.
Frequently asked questions (FAQs)
What does a blood pressure headache feel like?
There's no unique feeling that identifies a blood pressure headache. When headaches occur with very high blood pressure, they often feel pulsing or throbbing on both sides of the head, or there may be pressure at the back of the head or behind the eyes. However, these symptoms can also occur with other types of headaches like tension headaches or migraines. What makes a headache concerning in the context of high blood pressure is when it occurs along with very high readings (approaching or above 180/120) or other symptoms like vision changes, confusion, or chest pain.
How do you get rid of a high blood pressure headache?
There's no guaranteed instant fix. The most important step is to address the underlying blood pressure issue safely. If your blood pressure is very high (180/120 or above) with symptoms, seek immediate medical care. If it's elevated but not in the crisis range, work with your provider to adjust your medications as needed. Don't double-dose medications on your own. You can also try basic headache relief techniques like rest in a dark room, a cool compress, or relaxation techniques. Standard over-the-counter pain relievers may help if your provider has approved them, but the focus should be on safely managing your blood pressure.
Does high BP cause headaches?
Usually no. Mild to moderate high blood pressure typically doesn't cause headaches—hypertension is often called a “silent killer” because it usually has no noticeable symptoms. However, very high blood pressure (approaching or above 180/120 mmHg) or rapidly rising blood pressure can cause headaches. Additionally, factors that can raise blood pressure temporarily—like stress, pain, or caffeine—can also trigger headaches independently, creating an overlap without a direct cause-and-effect relationship.
How to bring down blood pressure?
If your blood pressure is very high (180/120 or above) with symptoms, seek immediate medical care—don't try to bring it down yourself. For ongoing management, work with your healthcare provider to develop a treatment plan that may include medications, lifestyle changes, or both. Lifestyle factors that help lower blood pressure over time include regular physical activity, a heart-healthy diet (like the DASH diet), maintaining a healthy weight, limiting sodium intake, managing stress, limiting alcohol, and getting adequate sleep. Never adjust medications on your own without your provider's guidance.
What are the 10 warning signs of high blood pressure?
High blood pressure is often called a “silent killer” because it typically has no warning signs. However, when blood pressure becomes very high (hypertensive crisis), symptoms may include: severe headache, vision changes or blurred vision, chest pain, shortness of breath, confusion, dizziness, nausea or vomiting, nosebleeds, irregular heartbeat, and fatigue. It's important to note that these symptoms usually only occur during a hypertensive crisis (blood pressure 180/120 or higher). Most people with high blood pressure have no symptoms at all, which is why regular blood pressure checks are important.
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