Headache in mild-to-moderate hypertension and its reduction by irbesartan therapy

Arch Intern Med. 2000 Jun 12;160(11):1654-8. doi: 10.1001/archinte.160.11.1654.


Background: Although it is generally acknowledged to be a problem in severe hypertension, headache has not been consistently associated with mild-to-moderate hypertension.

Patients and methods: In 7 randomized, double-blind, placebo-controlled trials, which included 2,673 patients with mild-to-moderate hypertension (defined as seated diastolic blood pressure of 95-110 mm Hg), patients were randomized to receive once-daily treatment with irbesartan, an angiotensin II receptor blocker (n= 1,987), or placebo (n=686). The data were pooled and analyzed retrospectively to determine whether the level of hypertension was associated with headache and whether antihypertensive therapy reduced the incidence of headache.

Results: Factors found to be predictive of headache incidence were diastolic blood pressure, sex (female), and age (<50 years). In comparison with placebo, the use of irbesartan was associated with a significant reduction in the incidence of headache (P=.003).

Conclusions: These data suggest that mild-to-moderate hypertension is not asymptomatic and that the incidence of headache can be reduced by antihypertensive treatment with a favorable adverse effect profile.

MeSH terms

  • Adult
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use*
  • Biphenyl Compounds / adverse effects
  • Biphenyl Compounds / therapeutic use*
  • Female
  • Headache / drug therapy*
  • Headache / epidemiology
  • Headache / etiology
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Incidence
  • Irbesartan
  • Logistic Models
  • Male
  • Middle Aged
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Tetrazoles / adverse effects
  • Tetrazoles / therapeutic use*


  • Antihypertensive Agents
  • Biphenyl Compounds
  • Tetrazoles
  • Irbesartan