期刊
JOURNAL OF ORAL & FACIAL PAIN AND HEADACHE
卷 36, 期 3, 页码 221-228出版社
QUINTESSENCE PUBLISHING CO INC
DOI: 10.11607/ofph.3174
关键词
autonomic dysregulation; glyceryl trinitrate; hypertension; migraine
资金
- Italian Ministry of Health
This study suggests that hypertension may contribute to the chronic evolution of headache by affecting vascular tone and autonomic regulation.
Aims: To investigate the potential contributions of diastolic and systolic blood pressure (BP) and the circadian rhythm of BP to chronic migraine evolution. Methods: This cross-sectional study included four groups of patients selected based on migraine frequency (high frequency >= 10 days per month and low frequency < 10) and on the presence of hypertension. Among-group and pairwise comparisons were carried outto investigate potential neurophysiologicdifferences in the cerebral vessel reactivity to a nitroglycerin test, in autonomic balance (tilting test), and BP circadian rhythm. Results: A more marked decrease in cerebral blood flow velocity was observed in hypertensive high-frequency migraineurs compared to all other groups (P = .037). Moreover, a smaller decrease in vagal tone was recorded in the orthostatic position in hypertensive subjects, whether they were high-(P= .032) or low-frequency migraineurs (P= .014), with a consistently higher vagal to sympathetic tone ratio (P = .033). Finally, in nonhypertensive subjects, a higher but not significant prevalence of systolic nondippers was detected in high-frequency migraineurs (67%) compared to low-frequency subjects (25%; P = .099). Conclusion: These findings suggest that hypertension may contrebute to the chronic evolution of headache with mechanisms shared with migraine; ie, vascular tone alteration and autonomic dysregulation.
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