Cluster headache and the heart.

Cluster headache is a rare but debilitating recurrent headache disorder. It is most common in middle-aged and older men, a group with a high prevalence of cardiovascular disease. This article reviews available information regarding the association of cluster headache and the heart in three selected areas: 1) the known effects of cluster headache on cardiovascular parameters such as heart rate and rhythm and blood pressure; 2) the prevalence of cardiac risk factors in subjects with cluster headache; and 3) the connection between patent foramen ovale and cluster headache. Some evidence suggests that cardiovascular risk factors, especially cigarette smoking, may be more common in cluster headache sufferers. There also is evidence that disturbances of autonomic function or certain structural cardiac anomalies may be more common in cluster headache sufferers. In addition, a number of important treatment options for cluster headache have effects on cardiovascular function that must be considered in planning therapy. The implications of these findings for clinical practice are discussed.