Key result
Pediatric primary headaches linked to higher ambulatory systolic BP despite normal office readings.
Why the study?
Children with primary headache may have elevated blood pressure load or impaired nocturnal dipping despite normal office blood pressure, but this is not well characterized.
Do children with primary headache exhibit abnormal ambulatory blood pressure profiles compared to healthy controls despite having normal office blood pressure?
Case-Control (n=74)
Do children with primary headache exhibit abnormal ambulatory blood pressure profiles compared to healthy controls despite having normal office blood pressure?
p-value: p=< 0.05
Children with primary headache disorders may have abnormal ambulatory blood pressure patterns despite normal office measurements, highlighting the potential utility of ABPM in this population.
ABPM may identify abnormal BP in children with primary headache despite normal office readings; hypothesis-generating and requires prospective validation before adoption.
OBJECTIVES: Headache is a common complaint in children and may indicate early hypertension (HT), an emerging concern in pediatrics. Children with primary headache (PH) may exhibit elevated blood pressure (BP) load or impaired nocturnal dipping despite normal office BP. This study aimed to evaluate the utility of ambulatory blood pressure monitoring (ABPM) in children with PH. METHODS: A case-control study was conducted including 37 children aged 8-17 years diagnosed with PH according to the International Classification of Headache Disorders (ICHD-3) criteria, all with office BP below the 95th percentile. Thirty-seven age- and sex-matched healthy subjects served as controls. Demographic, office BP, and ABPM parameters were compared between groups. RESULTS: Of the PH group, 81% (n = 30) had migraines and 19% (n = 7) had tension-type headache. No significant differences were found between groups regarding age, BMI SDS, or office systolic BP SDS. However, ABPM revealed significantly higher total, daytime, and nocturnal systolic BP, and increased nocturnal systolic and diastolic BP loads in the PH group (all p < 0.05). No differences were noted between headache subtypes. CONCLUSION: Children with PH may exhibit increased BP loads and disrupted BP patterns despite normal office measurements. ABPM appears to be a useful tool for accurately detecting subtle BP alterations in this population.
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Bolca et al. (2026) conducted a case-control in Primary headache disorders (n=74). Primary headache disorders vs. Healthy age- and sex-matched controls was evaluated on Ambulatory blood pressure monitoring parameters including total, daytime, and nocturnal systolic BP, and nocturnal BP loads (p=< 0.05). Children with primary headache disorders despite normal office blood pressure exhibited significantly higher total, daytime, and nocturnal systolic blood pressure on ABPM compared to controls (p < 0.05).
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