title: Elevated blood pressure and analgesic overuse in chronic daily headache: an outpatient clinic-based study from China.
abstract: BACKGROUND
  Many studies have reported that hypertension is common in chronic daily headache (CDH) and its subtype chronic migraine (CM), but the reason is still poorly understood. Our clinical literature review suggested that analgesic overuse may be associated with elevated blood pressure (BP), so we performed the present study to investigate the frequency of elevated BP and its link with analgesic overuse in CDH and its subtypes.
  
  
  METHODS
  A cross-sectional study was conducted in neurology outpatients with a diagnosis of CDH according to International Headache Society criteria. CDH patients were classified into CM and non-CM groups, and subclassified with or without analgesic overuse.
  
  
  RESULTS
  Elevated BP was present in 27.96% of CDH patients. Compared with non-CM patients, patients with CM had a longer duration of headache and more severe pain intensity, and a family history of headache and analgesic overuse were also more common, but the elevated BP frequency was not different between the two groups. Almost one-third of the patients had analgesic overuse; 96.8% of which comprised acetaminophen-containing agents. Those with analgesic overuse had a higher frequency of headache than those without analgesic overuse in both the CM and non-CM groups.
  
  
  CONCLUSIONS
  Although the CM patients had a longer duration of headache, more severe intensity, the frequency of elevated BP wasn't higher than non-CM group. Analgesic overuses maybe the reason of higher frequency of elevated BP in CDH and its subtypes. This may have predictive value for clinicians to improve CDH management.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Huang
authors.forename: Wangwen
authors.initials: W
authors.lastname: Li
authors.forename: Nan
authors.initials: N
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Ge
authors.initials: G
authors.lastname: Tan
authors.forename: Lixue
authors.initials: L
authors.lastname: Chen
authors.forename: Guangcheng
authors.initials: G
authors.lastname: Qin
authors.forename: Xiping
authors.initials: X
authors.lastname: Liang
authors.forename: Jiying
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000554:Ambulatory Care Facilities; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D020773:Headache Disorders / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders
chemical_list: D000700:Analgesics