Adolescent Migraines and Hypertension: A Call for Early Screening

A national cohort analysis of more than 2 million adolescents found migraine was associated with roughly threefold higher odds of hypertension, highlighting the need for earlier blood-pressure screening in youth. The association identifies a clear screening target in adolescent care.

Investigators reviewed Israeli medical records for more than 2 million adolescents, including about 61,000 with a migraine diagnosis, and observed a roughly threefold higher prevalence of hypertension among those with migraine. The association was strongest for severe or frequent migraine and remained after adjustment for common demographic factors, making this a population-scale finding with policy relevance.

The results reframe adolescent migraine as a potential vascular marker and support widening routine blood-pressure assessment for adolescents presenting with migraine. In practice, consider adding an immediate BP measurement at migraine visits and confirming elevated readings with repeat clinic measures or ambulatory monitoring when indicated.

Untreated hypertension beginning in adolescence may accelerate vascular risk and lead to earlier end-organ effects such as coronary disease, stroke, and renal impairment. Early detection through targeted screening of high-risk groups offers a practical prevention opportunity to blunt long-term cardiovascular harm.

Key Takeaways:

• Adolescents with migraine had roughly threefold higher odds of hypertension — consider routine BP checks at migraine visits.
• Frequent or severe migraine carried the strongest association — increase BP surveillance for these patients.
• Findings support incorporating BP screening into adolescent migraine care; piloting programmatic screening could inform guideline evolution and implementation.