We read with attention the article by Hansson et al1 regarding headache, hypertension, and therapy with irbesartan and question both the methods and the conclusions of this study. In their literature review, the authors omitted 2 seminal articles that do not show a positive association between headache and hypertension. Of 200 consecutive patients with hypertension studied by Stewart2 (96 of whom were aware of their blood pressure status) 71 (74%) complained of headache. In contrast, among the 104 persons who were not aware of their blood pressure status, only 17 (16%) complained of headache. Stewart concluded that once a patient became aware of the diagnosis of hypertension, the frequency of reported headache increases. Weiss3 found no association between self-reported headache and blood pressure in a cross-sectional study of 6672 participants of the US Health Examination Survey who were not aware of their blood pressure status.
Benseñor IM, Lotufo PA. Headache, Hypertension, and Irbesartan Therapy. Arch Intern Med. 2001;161(5):771-778. doi: