Healthy Tips

The different types of headaches depend upon the class to which they belong. Some common types include:

1. Primary tension headaches that are episodic
2. Primary tension headaches that are chromic
3. Primary muscle contraction headaches
4. Primary migraine headaches with aura
5. Primary migraine headaches without aura
6. Primary cluster headache
7. Primary paroxysmal hemicrania (a type of cluster headache)
8. Primary cough headache
9. Primary stabbing headache
10. Primary headache associated with sexual intercourse
11. Primary thunderclap headache
12. Hypnic headache (headaches that awaken a person from sleep)
13. Hemicrania continua (headaches that are persistently on one side only. right or left [unilateral])
14. New daily-persistent headache (NDPH) (a type of chronic headache)
15. Headache from exertion
16. Trigeminal neuralgia and other cranial nerve inflammation
17. Secondary headaches due to:

Trauma
Disorders
Infection
Structural problems with the bones of the face, teeth, eyes, ears, nose, sinuses or other structures
Substance abuse or withdrawa

What is a Headache?

Headache is defined as a pain arising from the head or upper neck of the body. The pain originates from the tissues and structures that surround the skull or the brain because the brain itself has no nerves that give rise to the sensation of pain (pain fibers). The thin layer of tissue (periosteum) that surrounds bones, muscles that encase the skull, sinuses, eyes, and ears, as well as thin tissues that cover the surface of the brain and spinal cord (meninges), arteries, veins, and nerves, all can become inflamed or irritated and cause headache. The pain may be a dull ache, sharp, throbbing, constant, intermittent, mild, or intense.

How are headaches classified?

In 2013, the International Headache Society released its latest classification system for headache. Because so many people suffer from headaches, and because treatment is difficult sometimes, it was hoped that the new classification system would help health-care professionals make a more specific diagnosis as to the type of headache a patient has, and allow better and more effective options for treatment.

The guidelines are extensive and the Headache Society recommends that health-care professionals consult the guidelines frequently to make certain of the diagnosis.

There are three major categories of headache based upon the source of the pain.

Primary headaches
Secondary headaches
Cranial neuralgias, facial pain, and other headaches
The guidelines also note that a patient may have symptoms that are consistent with more than one type of headache, and that more than one type of headache may be present at the same time.

Quick Guide
Migraine or Headache? Migraine Symptoms, Triggers, Treatment
Migraine or Headache? Migraine Symptoms, Triggers, Treatment
Migraine Triggers
A migraine is a throbbing painful headache, usually on one side of the head, that is often initiated or "triggered" by specific compounds or situations (environment, stress, hormones, and many others). They occur more often in women (75%, approximately) and may affect a person's ability to do common tasks.

Migraine headaches are often triggered to occur when the person is exposed to a specific set of circumstances.

flashing lights
anxiety and stress
lack of food or sleep
hormonal changes
foods (red wine, cheese, chocolate, soy sauce, processed meat, and MSG)
tyramine
caffeine

What are primary headaches?
Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.

Tension headaches are the most common type of primary headache. Tension headaches occur more commonly among women than men. According to the World Health Organization, 1 in 20 people in the developed world suffer with a daily tension headache.
Migraine headaches are the second most common type of primary headache. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected.
Cluster headaches are a rare type of primary headache. It more commonly affects men in their late 20s though women and children can also suffer from this type of headache.
Primary headaches can affect the quality of life. Some people have occasional headaches that resolve quickly while others are debilitating. While these headaches are not life threatening, they may be associated with symptoms that can mimic strokes.

Many patients equate severe headache with migraine, but the amount of pain does not determine the diagnosis of migraine. Read our Migraine Headache article for more information about the symptoms, causes, and treatment of migraines.


What are secondary headaches?
Secondary headaches are those that are due to an underlying structural or infectious problem in the head or neck. This is a very broad group of medical conditions ranging from dental pain from infected teeth or pain from an infected sinus, to life-threatening conditions like bleeding in the brain or infections like encephalitis or meningitis.

Traumatic headaches fall into this category including post-concussion headaches.

This group of headaches also includes those headaches associated with substance abuse and excess use of medications used to treat headaches (medication overuse headaches). "Hangover" headaches fall into this category as well. People who drink too much alcohol may waken with a well-established headache due to the effects of alcohol and dehydration.


What are cranial neuralgias, facial pain, and other headaches?
Neuralgia means nerve pain (neur=nerve + algia=pain). Cranial neuralgia describes inflammation of one of the 12 cranial nerves coming from the brain that control the muscles and carry sensory signals (such as pain) to and from the head and neck. Perhaps the most commonly recognized example is trigeminal neuralgia, which affects cranial nerve V (the trigeminal nerve), the sensory nerve that supplies the face and can cause intense facial pain when irritated or inflamed.

The aim of diabetes treatment is to bring blood sugar (“glucose”) as close to normal as possible. What is a normal blood sugar level? And how can you achieve normal blood sugar?

First, what is the difference between “sugar” and “glucose”? Sugar is the general name for sweet carbohydrates that dissolve in water. “Carbohydrate” means a food made only of carbon, oxygen, and hydrogen.

Advertisement
There are various different kinds of sugarbloos. The one our body uses most is called “glucose.” Other sugars we eat, like fructose from fruit or lactose from milk, are converted into glucose in our bodies. Then we can use them for energy. Our bodies also break down starches, which are sugars stuck together, into glucose.

When people talk about “blood sugar,” they mean “blood glucose.” The two terms mean the same thing.

In the U.S., blood sugar is normally measured in milligrams of glucose per deciliter of blood (mg/dl). A milligram is very little, about 0.00018 of a teaspoon. A deciliter is about 3 1/3 ounces.

In Canada and the United Kingdom, blood sugar is reported in millimoles/liter (mmol/L). You can convert Canadian or British glucose levels to American numbers if you multiply them by 18. This is useful to know if you’re reading comments or studies from England or Canada. If someone reports that their fasting blood glucose was 7, you can multiply that by 18 and get their U.S. glucose level of 126 mg/dl.

What are normal glucose numbers? They vary throughout the day. (Click here for a blood sugar chart.) For someone without diabetes, a fasting blood sugar on awakening should be under 100 mg/dl. Before-meal normal sugars are 70–99 mg/dl. “Postprandial” sugars taken two hours after meals should be less than 140 mg/dl.

Those are the normal numbers for someone without diabetes. If you have diabetes, the American Diabetes Association (ADA) advises keeping your blood sugar levels before meals from 80–130 mg/dl and your levels 1–2 hours after meals under 180. Many people with diabetes and doctors shoot for levels closer to those of people without diabetes, because they are more protective against complications. Lower numbers require more careful diet and more frequent monitoring to prevent lows, but they are doable for many people.

There is also a long-term glucose test called a hemoglobin A1c, HbA1c, or just A1C. This test gives your average reading over the last 2–3 months. HbA1c is expressed as a percentage. Normal for a person without diabetes is below 5.7%. Targets for a person with diabetes recommended by the ADA are lower than 7.0% if you want tight control.

When glucose levels get higher than normal, they start to cause inflammation in blood vessels and nerves. This is where all the complications of diabetes come from. So you don’t want high blood glucose levels.

In people without diabetes, normal insulin function keeps sugars in a normal range. When you have diabetes, insulin function is damaged. You need to give your body conscious help, by eating right, exercising, taking medications or herbs, and reducing stress.

Low blood sugars are also a potential problem. If you take insulin or a sulfonylurea or meglitinide drug, there is a risk of your blood sugar going too low. Low blood sugar (“hypoglycemia,” pronounced high-po-gleye-SEEM-e-uh) can cause dizziness, confusion, or fainting.

— Wondering if you might have diabetes? Learn about some common high blood sugar symptoms. >>

Normal blood glucose numbers

Fasting
Normal for person without diabetes: 70–99 mg/dl (3.9–5.5 mmol/L)
Official ADA recommendation for someone with diabetes: 80–130 mg/dl (4.4–7.2 mmol/L)

2 hours after meals
Normal for person without diabetes: Less than 140 mg/dl (7.8 mmol/L)
Official ADA recommendation for someone with diabetes: Less than 180 mg/dl (10.0 mmol/L)

HbA1c
Normal for person without diabetes: Less than 5.7%
Official ADA recommendation for someone with diabetes: Less than 7.0%

Learn blood sugar basics with our free guide!

Blood Sugar Basics

Testing your blood sugar

You can learn what your blood glucose is at a given moment with a fingerstick blood test, using any available glucose meter. It hurts a little, and the test strips cost money, but you can get good information. You can reduce the pain and the hassle of needle sticks and get more information with a continuous glucose monitor, or CGM. CGMs measure from a sensor inserted under the skin, often on the abdomen. (Currently, CGMs need to be calibrated roughly twice a day with a conventional blood sugar monitor.)

For people taking rapid-acting or intermediate-acting insulin, blood sugar testing should be frequent. You want to take the right amount and not have your blood sugar go too low.

For people with Type 2 diabetes who are not on insulin, how much to test is up to you. If you’re trying for tight control, you can test after eating different foods and doing different activities to see how they affect your glucose. Keep careful records of your results and perhaps log what you were eating and doing before your test.

It doesn’t help much to test at the same time every day, usually on waking and before dinner. Test with a plan; when you change something like a new medicine dose or an herb, then test in the days afterward. Many monitors keep your result records for you or send them to your computer or your doctor.

How low is too low for blood pressure?

Within certain limits, the lower your blood pressure reading is, the better. There is also no specific number at which day-to-day blood pressure is considered too low, as long as none of the symptoms of trouble are present.

Symptoms of low blood pressure 

Most doctors will only consider chronically low blood pressure as dangerous if it causes noticeable signs and symptoms, such as:

Dizziness or lightheadedness
Nausea
Fainting (syncope)
Dehydration and unusual thirst
Dehydration can sometimes cause blood pressure to drop. However, dehydration does not always cause low blood pressure. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can all lead to dehydration, a potentially serious condition in which your body loses more water than you take in. Even mild dehydration (a loss of as little as 1 percent to 2 percent of body weight) can cause weakness, dizziness and fatigue.
Lack of concentration
Blurred vision
Cold, clammy, pale skin
Rapid, shallow breathing
Fatigue
Depression
Underlying causes of low blood pressure

Low blood pressure can occur with:

Prolonged bed rest
Pregnancy
During the first 24 weeks of pregnancy, it’s common for blood pressure to drop.
Decreases in blood volume
A decrease in blood volume can also cause blood pressure to drop. A significant loss of blood from major trauma, dehydration or severe internal bleeding reduces blood volume, leading to a severe drop in blood pressure.
Certain medications
A number of drugs can cause low blood pressure, including diuretics and other drugs that treat hypertension; heart medications such as beta blockers; drugs for Parkinson’s disease; tricyclic antidepressants; erectile dysfunction drugs, particularly in combination with nitroglycerine; narcotics and alcohol. Other prescription and over-the-counter drugs may cause low blood pressure when taken in combination with high blood pressure medications.
Heart problems
Among the heart conditions that can lead to low blood pressure are an abnormally low heart rate (bradycardia), problems with heart valves, heart attack and heart failure. Your heart may not be able to circulate enough blood to meet your body’s needs.
Endocrine problems
Such problems include complications with hormone-producing glands in the body’s endocrine systems; specifically, an underactive thyroid (hypothyroidism), parathyroid disease, adrenal insufficiency (Addison’s disease), low blood sugar and, in some cases, diabetes.
Severe infection (septic shock)
Septic shock can occur when bacteria leave the original site of an infection (most often in the lungs, abdomen or urinary tract) and enter the bloodstream. The bacteria then produce toxins that affect blood vessels, leading to a profound and life-threatening decline in blood pressure.
Allergic reaction (anaphylaxis)
Anaphylactic shock is a sometimes-fatal allergic reaction that can occur in people who are highly sensitive to drugs such as penicillin, to certain foods such as peanuts or to bee or wasp stings. This type of shock is characterized by breathing problems, hives, itching, a swollen throat and a sudden, dramatic fall in blood pressure.
Neurally mediated hypotension
Unlike orthostatic hypotension, this disorder causes blood pressure to drop after standing for long periods, leading to symptoms such as dizziness, nausea and fainting. This condition primarily affects young people and occurs because of a miscommunication between the heart and the brain.
Nutritional deficiencies
A lack of the essential vitamins B-12 and folic acid can cause anemia, which in turn can lead to low blood pressure.
If you notice a sudden decline in blood pressure
A single lower-than-normal reading is not cause for alarm, unless you are experiencing any other symptoms or problems. If you experience any dizziness, lightheadedness, nausea or other symptoms, it’s a good idea to consult with your healthcare provider. To help with your diagnosis, keep a record of your symptoms and activities at the time they occurred.

High blood pressure is also known as hypertension. Blood pressure is the amount of force exerted against the walls of the arteries as blood flows through them.

In the United States, approximately 85 million people have high blood pressure - about 1 in every 3 adults over 20, according to the American Heart Association (AHA).

The National Institutes of Health (NIH) estimate that about two-thirds of people over the age of 65 in the U.S. have high blood pressure.

If left untreated or uncontrolled, high blood pressure can cause many health problems. These conditions include heart failure, vision loss, stroke, and kidney disease.

Causes

An older man is having his blood pressure measured by a woman.
The risk of developing hypertension increases as people age.
The heart is a muscle that pumps blood around the body.

Blood that has low oxygen levels is pumped towards the lungs, where oxygen supplies are replenished. The oxygen rich blood is then pumped by the heart around the body to supply our muscles and cells. The pumping of blood creates pressure.

If a person has high blood pressure, it means that the walls of the arteries are receiving too much pressure on a constant basis.

The causes of high blood pressure are divided into two categories:

Essential high blood pressure: This has no established cause.
Secondary high blood pressure: There is an underlying cause.
Even though there is no identifiable cause for essential high blood pressure, there is strong evidence linking some risk factors to the likelihood of developing the condition.

Most of the causes below are risk factors for essential high blood pressure. There are also examples of secondary high blood pressure:

1) Age

The older you are the higher your risk of having high blood pressure.

2) Family history

If you have close family members with hypertension, your chances of developing it are significantly higher. An international scientific study identified eight common genetic differences that may increase the risk of high blood pressure.

3) Temperature

A study that monitored 8,801 participants over the age of 65 found that systolic and diastolic blood pressure values differed significantly across the year and according to the distribution of outdoor temperature. Blood pressure was lower when it got warmer, and rose when it got colder.

4) Ethnic background

Evidence indicates that people with African or South Asian ancestry have a higher risk of developing hypertension, compared to people with predominantly Caucasian or Amerindian (indigenous of the Americas) ancestries.

5) Obesity and overweight

Both overweight and obese people are more likely to develop high blood pressure, compared to people of normal weight.

6) Some aspects of gender

In general, high blood pressure is more common among adult men than adult women. However, after the age of 60 years both men and women are equally susceptible.

7) Physical inactivity

Lack of exercise, as well as having a sedentary lifestyle, raises the risk of hypertension.

8) Smoking

Smoking causes the blood vessels to narrow, resulting in higher blood pressure. Smoking also reduces the blood's oxygen content so the heart has to pump faster in order to compensate, causing a rise in blood pressure.

9) Alcohol intake

People who drink regularly have higher systolic blood pressure than people who do not, according to researchers. They found that systolic blood pressure levels are about 7 millimeters of mercury (mmHg) higher in people who drink frequently than in people who do not drink.

10) High salt intake

Researchers reported that societies where people do not eat much salt have lower blood pressures than places where people eat a lot of salt.

11) High fat diet

Many health professionals say that a diet high in fat leads to a raised high blood pressure risk. However, most dietitians stress that the problem is not how much fat is consumed, but rather what type of fats.

Fats sourced from plants such as avocados, nuts, olive oil, and omega oils are good for you. Saturated fats, which are common in animal-sourced foods, as well as trans fats, are bad for you.

12) Mental stress

Various studies have offered compelling evidence that mental stress, especially over the long term, can have a serious impact on blood pressure. One study suggested that the way that air traffic controllers handle stress can affect whether they are at risk of developing high blood pressure later in life.

13) Diabetes

People with diabetes are at a higher risk of developing hypertension. Among people with type 1 diabetes, high blood sugar is a risk factor for incident hypertension - effective and consistent blood sugar control, with insulin, reduces the long-term risk of developing hypertension.

People with type 2 diabetes are at risk of hypertension due to high blood sugar, as well as other factors, such as overweight and obesity, certain medications, and some cardiovascular diseases.

14) Psoriasis

A study that followed 78,000 women for 14 years found that having psoriasis was linked to a higher risk of developing high blood pressure and diabetes. Psoriasis is an immune system condition that appears on the skin in the form of thick, red scaly patches.

15) Pregnancy

Pregnant women have a higher risk of developing hypertension than women of the same age who are not pregnant. It is the most common medical problem encountered during pregnancy, complicating 2 to 3 percent of all pregnancies.

Signs and symptoms

Most people with high blood pressure will not experience any symptoms. It is often known as the "silent killer" for this reason.

However, once blood pressure reaches about 180/110 mmHg, it is considered a medical emergency known as a hypertensive crisis. At this stage, symptoms will show, including:

headache
nausea
vomiting
dizziness
blurred or double vision
nosebleeds.
palpitations, or irregular or forceful beating of the heart
breathlessness
Anybody who experiences these symptoms should see their doctor immediately.

Children with high blood pressure may have the following signs and symptoms:

headache
fatigue
blurred vision
nosebleeds
Bell's palsy, or an inability to control facial muscles on one side of the face.
Newborns and very young babies with high blood pressure may experience the following signs and symptoms:

failure to thrive
seizure
irritability
lethargy
respiratory distress
People who are diagnosed with high blood pressure should have their blood pressure checked frequently. Even if yours is normal, you should have it checked at least once every five years, and more often if you have any contributory factors.

Complications

If the hypertension is not treated or controlled the excessive pressure on the artery walls can lead to damage of the blood vessels (cardiovascular disease), as well as vital organs. The extent of damage depends on two factors; the severity of the hypertension and how long it goes on for untreated.

Below is a list of some of the possible complications of high blood pressure:

stroke
heart attack and heart failure
blood clots
aneurysm
kidney disease
thickened, narrow, or torn blood vessels in the eyes
metabolic syndrome
brain function and memory problems

Treatment

Treatment for high blood pressure depends on several factors, such its severity, associated risks of developing stroke or cardiovascular, disease, etc.

Slightly elevated blood pressure
The doctor may suggest some lifestyle changes if blood pressure is only slightly elevated and the risk of developing cardiovascular disease considered to be small.

Moderately high blood pressure
If blood pressure is moderately high and the doctors believes the risk of developing cardiovascular disease during the next ten years is above 20 percent, the doctor will probably prescribe medication and advised on lifestyle changes.

Severe hypertension
If blood pressure levels are 180/110 mmHg or higher, the doctor will refer the individual to a specialist.

Changes in lifestyle can help lower high blood pressure
The following are recommended lifestyle changes that can help you lower your blood pressure. Note that you should always check with a Doctor or healthcare professional to discuss lifestyle changes before making any dramatic changes yourself.

Regular exercise
Senior couple exercising
A regular program of exercise can prove beneficial in lowering blood pressure.
Exercising for 30 to 60 minutes five days a week will usually lower a person's blood pressure by 4 to 9 mmHg. If you embark on an exercise program you should see the benefits fairly soon - within a matter of two to three weeks, especially if you have been leading a sedentary lifestyle for a long time.

It is important to make sure you check with your doctor before embarking on any physical activity program. Exercise needs to be tailored to the needs and health of the person with hypertension.

The secret of getting success out of exercise is to do it regularly. Exercising at weekends and doing nothing from Monday to Friday will be much less effective.

Losing weight
Studies have revealed that even moderate weight loss - just ten pounds - can have a significant impact in lowering elevated blood pressure.

If you are overweight, the nearer you get to your ideal weight the more your blood pressure is likely to fall. Any high blood pressure medications you are taking will become more effective when you lose weight.

Reducing your waistline will have the greatest effect. Achieving a healthy body weight involves a combination of exercise, good diet, and at least 7 hours good quality sleep each night.

Scientists at Kaiser Permanente's Center for Health Research discovered that keeping a food diary can double weight loss as part of a managed program.


Relaxation techniques
Researchers at Massachusetts General Hospital found that adding the relaxation response, a stress-management approach, to other lifestyle modifications may significantly improve treatment of the type of hypertension most common in the elderly.

Harvard Women's Health Watch reported that in one study, tai chi significantly boosted exercise capacity, lowered blood pressure, and improved levels of cholesterol, triglycerides, insulin, and C-reactive protein in people at high risk for heart disease.

Sleep
Not getting enough sleep can increase a person's risk of developing high blood pressure, scientists from the University of Chicago reported after monitoring over 500 middle aged people for 5 years.

Some studies have suggested that adults sleep no less than 7 hours and no more than 8 hours per day. In 2008 the American Academy of Sleep Medicine published a study suggesting that people with sleep duration above or below the recommended 7-to-8 hours per night face an increased risk of hypertension.

There are several anti-hypertensive medications on the market today. Some people may need to take a combination of different drugs to effectively control their high blood pressure.

Some people may have to be on medication to control hypertension for the rest of their lives. Doctors may advise discontinuing treatment if the individual has managed to maintain good blood pressure levels for a given period, and is not considered to be at significant risk of stroke or cardiovascular disease.

One study found that people have more control of their high blood pressure when treated with less
 medication.

Diet

Managing the diet can be effective way of both preventing and treating high blood pressure.

This means eating plenty of fruits and vegetables, good quality unrefined carbohydrates, vegetable oils, and omega oils. If you eat animal products make sure all the fat is trimmed and avoid processed meats.

Lowering salt intake
Studies have shown that even a moderate reduction in salt, or sodium, intake can lower blood pressure levels by 2 to 8 mmHg.

A study found that most Americans who are diagnosed with hypertension still consume more than the recommended levels of salt.

Study leader, Umed Ajani, an epidemiologist with the National Center for Chronic Disease Prevention and Promotion, said:

"Perhaps the most striking finding is that no difference in sodium intake was observed between those who received advice and those who did not."
A report published in March, 2009 by the Centers for Disease Control and Prevention (CDC) suggests that 7 in every 10 adult Americans should limit their sodium intake to 1,500 mg a day. The report estimated that 145 million Americans have one of three risk factors for hypertension. This is equal to roughly 70 percent of the adult population.

The AHA provide a useful table that lists common measurements of salt and their mg equivalents.

The DASH diet
The NIH designed a diet to control blood pressure called the DASH diet. It is also recommended by the AHA.

This diet is based on an eating plan that focuses on fruits, vegetables, nuts, seeds, beans, and low-fat dairy products.

Click here for a table advising the proportions of each food type to include for people wanting to follow the DASH diet.

Alcohol
Some studies indicate that consuming alcohol helps lower blood pressure, while others report the opposite.

In very small amounts, alcohol may lower blood pressure. But if you drink too much, even moderate amounts in some cases, blood pressure levels may increase.

People who drink more than moderate amounts of alcohol regularly will almost always experience elevated blood pressure levels.

Caffeine
There is a wide range of studies that report on whether caffeine has an impact on blood pressure. Many have conflicting conclusions but agree that moderating caffeine intake is advisable for people with high blood pressure.

Ranges
Blood pressure meter and stethoscope
High blood pressure is considered to be 140/90 mmHg or higher.
Anyone whose blood pressure is 140/90 mmHg or more for a sustained period is said to have high blood pressure, or hypertension.

Blood pressure is usually divided into five categories:

 Hypotension, or low blood pressure
Systolic mmHg 90 or less, or
Diastolic mmHg 60 or less
 Normal
Systolic mmHg 90-119, and
Diastolic mmHg 60-79
 Prehypertension
Systolic mmHg 120-139, or
Diastolic mmHg 80-89
 Stage 1 Hypertension
Systolic mmHg 140-159, or
Diastolic mmHg 90-99
 Stage 2 Hypertension
Systolic mmHg over 160, or
Diastolic mmHg over 100