Blood Pressure Changes in Migraine Patients before, during and after Migraine Attacks

Abstract

Migraine attacks are characterized by headaches associated with neurological, gastrointestinal, and autonomic symptoms. A relationship between migraine and hypertension or hypotension is controversial. In this study, we aimed to determine if blood pressure changes were related to migraine attacks. From the outpatient clinic of our neurology department, 62 normotensive migraine patients with and without aura were chosen for study in accordance with the International Headache Society 2004 criteria. A questionnaire including general and specific questions was given to the patients to be filled out during 6 consequent migraine attacks. The patients received a fully automatic digital brachial upper arm sphygmomanometer (Omron M 4-1) to measure the changes in their blood pressure during attacks. The patients were asked to record their blood pressure changes 3 times: (1) just before or very early, (2) during (when headache peaks), and (3) 1 hour after the attack. Twenty-three of the 62 patients (57 women, 5 men) had migraine with aura (22 women and 1 man), and 39 of them did not have aura (35 women and 4 men). There was no statistically significant difference between systolic and diastolic values obtained before or very early, during the peak level, and 1 hour after the end of the attacks (P > 0.05). Although diastolic hypotensive values were not different statistically between groups, when all the patients were considered, diastolic hypotensive values were detected in a considerable number of patients (a total of 115 measurements). In this normotensive migrainous population, we observed that diastolic hypotension before or very early, during, and after migraine attack was the most significant result (5.1%). Although it was not statistically significant, the total number of hypotensive values was remarkable.

Migraine: Possible Role of Shear‐Induced Platelet Aggregation With Serotonin Release

“…Figure 1 additionally shows that strong platelet aggregation was accompanied by a marked decline in mean aortic pressure. This decline was prevented by clopidogrel 9 or L‐NMA 8 and reminds to the diastolic hypotension (pressure below 60 mmHg) observed in a number of patients during migraine attacks 66 . It is conceivable that the hypotension in migraine contributes to, or may be part of, the autonomic dysfunction that causes nausea and emesis.…”

“…This decline was prevented by clopidogrel 9 or L-NMA 8 and reminds to the diastolic hypotension (pressure below 60 mmHg) observed in a number of patients during migraine attacks. 66 It is conceivable that the hypotension in migraine contributes to, or may be part of, the autonomic dysfunction that causes nausea and emesis. Such dysfunction might result from increased plasma levels of serotonin that stimulate 5-HT3 receptors on the parasympathetic nuclei in the area postrema, located outside the blood-brain barrier.An increase of vagal motor activity will, on its turn, stimulate release of serotonin from enterochromaffin cells, further exciting vagal activity in a positive serotonergic-parasympathetic feedback loop.…”

Metabolic Syndrome and Migraine

“…However, other studies have associated systolic hypertension with chronic daily headache (Gipponi et al, 2010) and chronic migraine (Bigal et al, 2002; Barbanti et al, 2010), but not episodic migraine or tension-type headache in non-pregnant adult patients. Diastolic hypertension has been associated with increased frequency of episodic migraine in one study (Gudmundsson et al, 2006) but diastolic hypotension was non-significantly associated with migraine in another study (Seçil et al, 2010). Some have suggested that autonomic dysfunction is an important part of migraine; many migraineurs exhibit symptoms, such as diarrhea or sweating, of parasympathetic over-activity (Melek et al, 2007).…”

Magnesium in Man: Implications for Health and Disease

“…Therefore, patients with an increase in neuronal excitability due to low CSF Mg 2ϩ levels are more susceptible to migraine attacks. Moreover, patients suffering from migraine are often hypotensive during attacks (462), which can be explained by increased NO levels. NO is an important vasodilator and modulator of brain blood flow (376).…”