Blood pressure headache

I think she may have oversimplified it. While headaches CAN be caused by blood pressure, your readings never get high enough for that to be the cause, which is why you’ve been told it isn’t your blood pressure. Your numbers are very well controlled, and if high BP were responsible, it would clearly show up in your readings, which it doesn’t. This doesn’t mean your blood pressure is elevated nonstop.
Well controlled blood pressure, like yours, does not cause chronic tension headaches. Headaches that last for weeks aren’t a sign of sustained high BP, especially when readings are normal. If anything, it may have been a brief spike that came back down quickly, and that doesn’t cause long term harm.
You don’t have weeks long high blood pressure. What you’re experiencing fits tension headaches, made worse by stress, muscle tension, and TMJ, not dangerous hypertension, especially since your BP readings are fairly normal.

Your NP is very knowledgeable and you should definitely listen to her, but it’s also worth remembering that medical explanations are sometimes simplified. The propranolol should help a lot.
It sounds like you otherwise had a good appointment, especially considering how stressed you were beforehand.

@ashlynnmae

Idk she said TMJ headaches don't really happen in that area which I believe. And she said tension headaches and high BP go hand in hand. She seemed very knowledgeable.

@ehdog

She is knowledgeable, and two things can be true at the same time. TMJ headaches don’t only show up in one “classic" location. They can occur in the temples, around or behind the eyes, the forehead, scalp, neck, base of the skull, and even the back of the head. A lot of this is referred pain.
Jaw tension can cause pain throughout the head because the jaw, temples, neck, and scalp muscles are all connected. So TMJ can absolutely cause headaches outside the jaw itself.
Tension headaches and blood pressure don’t really “go hand in hand” the way that phrase can sound. What actually tends to go together is stress and adrenaline, muscle tension, and temporary blood pressure bumps. That’s very different from hypertension causing headaches.
Sustained high blood pressure only causes headaches when it’s extremely high, and it would clearly show up in readings. You don’t have that, your numbers are controlled. If your BP were high enough to cause headaches, you’d be fainting, falling over, and ending up in the ER.
So when she linked tension headaches and BP, she was talking about stress physiology, not blood pressure being elevated for weeks. That’s also why propranolol makes sense: it reduces adrenaline, relaxes the physical stress response, helps with tension type headaches, and lowers BP a bit as a bonus. She was smart to prescribe it.
Trusting her expertise doesn’t mean assuming you’ve had dangerous blood pressure for weeks. It just means she explained it broadly. Bottom line: you can trust that she knows her stuff and still know that your headaches aren’t from weeks long high blood pressure.

@ehdog

She is knowledgeable, and two things can be true at the same time. TMJ headaches don’t only show up in one “classic" location. They can occur in the temples, around or behind the eyes, the forehead, scalp, neck, base of the skull, and even the back of the head. A lot of this is referred pain.
Jaw tension can cause pain throughout the head because the jaw, temples, neck, and scalp muscles are all connected. So TMJ can absolutely cause headaches outside the jaw itself.
Tension headaches and blood pressure don’t really “go hand in hand” the way that phrase can sound. What actually tends to go together is stress and adrenaline, muscle tension, and temporary blood pressure bumps. That’s very different from hypertension causing headaches.
Sustained high blood pressure only causes headaches when it’s extremely high, and it would clearly show up in readings. You don’t have that, your numbers are controlled. If your BP were high enough to cause headaches, you’d be fainting, falling over, and ending up in the ER.
So when she linked tension headaches and BP, she was talking about stress physiology, not blood pressure being elevated for weeks. That’s also why propranolol makes sense: it reduces adrenaline, relaxes the physical stress response, helps with tension type headaches, and lowers BP a bit as a bonus. She was smart to prescribe it.
Trusting her expertise doesn’t mean assuming you’ve had dangerous blood pressure for weeks. It just means she explained it broadly. Bottom line: you can trust that she knows her stuff and still know that your headaches aren’t from weeks long high blood pressure.

@ashlynnmae

I was moving when they put theirs on me plus it was a wrist one which I don't trust as much

@ehdog

That’s a really common question, and it makes sense to be confused. Tension headaches aren’t caused by sustained high blood pressure, they’re caused by muscle tension, stress, and nerve sensitivity. Once a headache starts, it can linger for days or even weeks, even though your blood pressure stays normal the whole time. Something like stress, TMJ, jaw clenching, or neck tension can trigger it, and then your muscles stay tight and your nerves stay sensitized, keeping your body stuck in a “pain loop.” The headache keeps going because the muscles and nerves haven’t relaxed yet, not because your BP is high. Your blood pressure may spike briefly during stress or pain, but that’s temporary and doesn’t sustain the headache. So essentially, your muscles and nerves are driving the pain for weeks, not your blood pressure.

Even if your reading was slightly off in office due to moving or lower down, it would actually be a little lower rather than the higher reading , so a reading of 114/80 would probably be closer to 110/70 or 109/70, which is still very normal. Great even.

@ashlynnmae

It was 160 on my cuff that always seems to be fairly accurate at home

thought palpitations were normal. I get them resting not when I'm anxious. I thought the headaches were Just tension but they're not they're from my blood pressure spiking
It's awful I cried a bit at my appointment because I was anxious.

@ehdog Anxiety-induced high BP readings are a well-known "thing" - it even has a name White Coat Syndrome."
Didi your doctor explain why the added propanolol to your prescriptions?