Blood Pressure Variability In Patients With Migraine Headache

Objective To study the 24-hour ambulatory blood pressure variability (BPV) and autonomic system functions in patients with migraine headache.Methods The blood pressure variability, representing the function of circadian feature of the autonomic modulation in 10 patients with migraine free from drug during stage of headache-free intervals, was studied and compared with results of an age-matched control group of 12 healthy volunteers. Time domain analysis of the BPV was implemented for each subject. The centricity of the BPV represented by Mean+Standard Deviation(SD) and the Root Mean of Squared Successive Differences (RMSSD) of the systolic pressure, diastolic pressure and mean arterial pressure at daytime(T1),night time(T2) and the whole day(T3) were calculated separately. The circadian features, (T1-T2)/T1 of SBP was designed to determine whether it is a dipper pattern. Sleep through morning surge and pre awakening morning surge were measures of the morning shift of the autonomic system functions.Results All the means of migraine patients were lower than these counterpoints of control group, and the statistically significant differences between the two groups lied in T1's SBP DBP and MAP, T2's MAP, T3's SBP, DBP and MAP, RMSSD T1's SBP and DBP, RMSSD T2's DBP and RMSSD T3's SBP and DBP. There was a significant decrease in the expected BP decline during sleep in patients compared to controls. Also,6 dipper patterns and 4 non-dippers in migraine patients and 12 dippers in control group were revealed and the difference of constituent ratio between these two groups was statistically significant. The decrease of S2 in observation group was statistical significant comparing to the control group. The sleep through DBP and MAP, the after awakening SBP, DBP and MAP were significantly lower in migraineurs than in controls.Conclusion The migraine patients presented the alternations of the 24-hour BPV pattern and showed hypofunction of the sympathetic system. This provides further evidence that migraine is derived from the imbalance of the central nervous system. It may make sense that the central nervous origination of migraine and the central modulation of BPV share some common anatomy structures (brain stem and hypothalamus) and neurotransmitters (CGRP). In addition, the ambulatory blood pressure monitoring enables us to quantify the variance of the ANS function in migraine.