American Heart Month: Why Your Neurologist Is Concerned About Your Heart Health

Headaches of all kinds can occur when the cardiovascular system is not working correctly. For example, when your blood pressure is consistently high, the walls of the blood vessels take a pounding. This high pressure can lead to a break in the vessel wall, or a dissection. It can also lead to a small pouch forming in the wall of the blood vessel, or an aneurysm. Both aneurysms and dissections can result in significant headaches. Regarding specific types of headaches, patients with migraines are more likely to have cardiovascular problems such as heart attacks or strokes.

Damage to your blood vessels can lead to conditions that can cause severe, serious, and even life-threatening headaches.

• Having high blood pressure on top of cholesterol problems and tobacco use can cause the walls of the blood vessels to weaken.
• A break in the wall of the blood vessels supplying the brain can cause a dissection, while the formation of a small pouch in this vessel can cause an aneurysm.
• A dissected vessel can cause serious pain in the head, and if it blocks the vessel, it can also cause a stroke.
• An aneurysm can cause a headache. If it ruptures, it can cause a severe, life-threatening bleed in the brain associated with the worst headache of one’s life.

Migraines are associated with an increased risk of heart attacks and strokes.

• Patients with migraines have higher risk for strokes and heart attacks.
• This association is especially important in patients who have a warning, or an aura, before their migraine attacks.
• Estrogen-containing hormonal therapy can worsen this association, making women with migraines even more likely to have a stroke or a heart attack due to increasing the risk for blood clotting and increasing cholesterol and blood pressure.

Therefore, it is important to know when a headache is not just a headache.

• A new headache that comes on suddenly at its absolute worst is concerning for a cardiovascular event such as an aneurysm, dissection, or stroke.
• A headache accompanied by a sudden onset of neurologic symptoms affecting part of your body (weakness or numbness on one side of your body, slurred or garbled speech, facial droop, vertigo) may represent a stroke and needs to be evaluated in the emergency room immediately.
• A new type of headache that is different and more severe than your typical migraines needs to be evaluated by your neurologist to make sure there is no other more dangerous cause.

Therefore, headaches can be associated with cardiovascular disease. Severe, life-threatening causes of headaches can occur when the blood vessels going to the brain are damaged, and migraines are associated with an increased risk of stroke or heart attacks. The good news is that by maintaining a health low cholesterol and low sugar diet, exercising, controlling your blood pressure, and avoiding cigarette smoke, you can get a two-for-one: you can keep your heart healthy while also reducing your risk for life-threatening headaches.