A case of late diagnosis of the clinical phenotype «tension-type headache and arterial hypertension»

Today special attention is paid to the issues of comorbidity of particularly common nosologies due to the active introduction into clinical practice of the principles of an individual approach to the treatment of each patient. This article is devoted to the clinical phenotype «tension-type headache and arterial hypertension». Its timely diagnosis is of great importance, as a timely correct diagnosis will increase the effectiveness and safety of treatment, improve the quality of life of patients, as well as reduce the risk of cardiovascular complications. This article presents a clinical case of a 56-year-old patient who applied to the Department of General Medical Practice of Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University with complaints of increased frequency of attacks of chronic headache. She had a long history of headache and high blood pressure, burdened with a hereditary history on the mother's side of tension-type headache and arterial hypertension. She had been self-medicating for a long time and had low compliance with hypotensive and analgesic therapy. During the examination, which includes neurological examination, the use of specialized scales and questionnaires to assess the presence of cognitive-affective disorders, the assessment of the subjective sensation of pain using a digital analog scale, laboratory and instrumental research methods, night respiratory monitoring, as well as analysis of the headache diary, indices of time lost due to headache, and the effects of headache, daytime sleepiness scales and response to headache therapy, two diseases of tension-type headache and arterial hypertension were identified, proceeding independently and independently of each other, while significantly aggravating the course of each other (i.e. clinical phenotype). Taking into account the results obtained, the therapy was adjusted, the patient was registered with a neurologist, cardiologist. The conclusion is made about the importance of an integrated and interdisciplinary approach in the management of patients with the clinical phenotype «tension-type headache and arterial hypertension».

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