Nocturnal Headache-Hypertension Syndrome: A Chronobiologic Disorder

Pietro Cugini Endocrine Pathophysiology, Chronobiology Unit, University of Rome, La Sapienza, Rome, Italy

Massimo Granata VI Medical Pathology, Headache Center, University of Rome, La Sapienza, Rome, Italy

Stefano Strano Clinical Methodology, Hypertension Service, University of Rome, La Sapienza, Rome, Italy

Andrea Ferrucci Clinical Methodology, Hypertension Service, University of Rome, La Sapienza, Rome, Italy

Giuseppino Massimo Ciavarella Clinical Methodology, Hypertension Service, University of Rome, La Sapienza, Rome, Italy

Loredana Di Palma Endocrine Pathophysiology, Chronobiology Unit, University of Rome, La Sapienza, Rome, Italy

Giuseppe Leone Endocrine Pathophysiology, Chronobiology Unit, University of Rome, La Sapienza, Rome, Italy

Mario Giacovazzo VI Medical Pathology, Headache Center, University of Rome, La Sapienza, Rome, Italy

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Abstract

The study of blood pressure (BP) monitoring in essential hypertensive patients recurrently suffering from nocturnal headache revealed a rhythmic elevation of sphygmomanometric values during the night. Such a finding was not detected in essential hypertensive patients suffering from occasional headache. The nocturnal elevation of BP was seen to be paralleled by the circadian peak of heart rate, suggesting that the disorder is a systemic phenomenon. Importantly, the headache episodes were seen to disappear after antihypertensive therapy that was adjusted to lower the nocturnal increase of BP. The therapeutic results suggested that the nocturnal headache was dependent on the phasic elevation of BP. The beneficial effects further suggested that the nocturnal headache and the nocturnal elevation of BP may represent a particular syndrome with a cause-effect relationship. The term “nocturnal headache-hypertension syndrome” is proposed.

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Nocturnal Headache-Hypertension Syndrome: A Chronobiologic Disorder

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