Another source of investigation is whether, if these comorbid dis

Another source of investigation is whether, if these comorbid disorders are effectively managed, the migraines will improve or become more treatable. It is common to think of migraines as being related to blood vessels or vascular in origin, despite evidence to the

contrary. There is a throbbing nature to the pain, and that suggests blood vessels. Migraines worsen PLX3397 with stress and exercise, are associated with an increase in blood pressure with pain, and have symptoms that at times can resemble strokes. Cardiovascular conditions believed to be possibly increased in frequency with migraine include Raynaud’s phenomenon (see below for a definition), high blood pressure (inconsistently), and ischemic heart disease. Structural heart conditions are sometimes linked with migraine and these include changes in the heart chambers and valves. These disorders are not believed to cause migraine, but they may occur more frequently in those who have migraine. It is perhaps easiest to look at common vascular disorders and examine their frequency with migraine, as well as the implications for treatment. Recurring headaches over time accompanied by symptoms of migraine are unlikely to be blood vessel in origin. A clue that points to an underlying urgent vascular condition is usually a sudden, new headache, one never before experienced by the patient and occurring like a “thunderclap.” Whenever this occurs, vascular conditions

should be looked for promptly. It has long been assumed by both physicians and selleck inhibitor patients alike that high blood pressure or hypertension

caused headaches. One very interesting selleckchem study found that if patients knew they had high blood pressure, 74% also said they had headache. If the patient did not know they had high blood pressure, only 16% said they had headache. Large studies have backed this up, that if a patient does not know they have hypertension, no increase was found in headache frequency. Other studies have estimated a risk of hypertension to be twice as high in migraineurs. A study of 21,537 individuals published in the medical journal Cephalalgia in 2006 showed that elevations in diastolic blood pressure (the lower number), not systolic blood pressure (the top number), were correlated with migraine. This would explain why there are such inconsistent findings in studies of migraine associations with hypertension. Most studies do not break down whether the blood pressure elevation is diastolic or systolic. In 2004, the International Headache Society came to the conclusion that chronic mild to moderate elevated blood pressure does not cause headache. Current guidelines require that headaches caused by high blood pressure, and it has to be very high, must go away once the blood pressure drops to normal. At the time of the headache, the systolic blood pressure must be at least 180 and/or the diastolic 120.

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