Hypertension does not usually cause any noticeable symptoms. When it does, you might experience dizziness, shortness of breath, headaches, and nosebleeds, which could indicate that your blood pressure is high.1 Complications such as heart disease, stroke, and kidney failure can occur if long-term hypertension is not adequately treated. A hypertensive emergency, which is an uncommon and dangerous event, may cause blurry vision, nausea, chest pain and anxiety.2
Overall, the vast majority of people who have hypertension, which is described as chronically high blood pressure (>130 mm Hg or diastolic pressure >80 mm Hg), do not experience any symptoms of the condition. It is usually diagnosed in the doctor’s office with a simple blood pressure measurement using a blood pressure cuff.
Symptoms that do occur, if present, may indicate temporary fluctuations or elevations in blood pressure, and can be related to the timing of medication doses. Generally, the symptoms of hypertension can happen at any time, do not last for long, and may recur. They include:
- Recurrent headaches: Headaches are fairly common among people with or without hypertension. Some people with hypertension notice changes or worsening of headaches when medications are skipped or when the blood pressure becomes higher than usual. Headaches associated with hypertension can be mild, moderate, or severe3 and can be of a throbbing nature.
- Dizziness: People with hypertension may notice dizziness in relation to medication doses and blood pressure fluctuations.
- Shortness of breath: Hypertension can cause shortness of breath as a result of the effect on the heart and lung function.4 Shortness of breath is more noticeable with physical exertion or exercise.
- Nosebleed: You may be more prone to nosebleeds if you have hypertension, although, in general, nosebleeds are not a classic sign of high blood pressure.
Extremely high blood pressure that occurs suddenly is more likely to produce noticeable symptoms than chronic hypertension. However, it is important to know that even very high blood pressure may not produce symptoms.
- Blurry vision or other vision disturbances: Blurred vision and vision changes are warning signs that you could be at risk of a serious health problem, such as a stroke or a heart attack.5
- Headaches: Headaches associated with very high blood pressure tend to be throbbing in nature and can develop rapidly.
- Dizziness: The dizziness of very high blood pressure is described as vertigo (a sensation that the room is spinning).6
- Nausea, vomiting or loss of appetite: Nausea associated with severe hypertension can develop suddenly and may be associated with dizziness.
A type of high blood pressure without serious symptoms is called hypertensive urgency.
Hypertensive urgency is defined as a systolic blood pressure of >180 mm Hg and a diastolic blood pressure of >120 mm Hg. This blood pressure is considered high enough to put you at serious risk of sudden, life-threatening events.
In situations of hypertensive urgency, there is no organ failure or other immediately critical conditions, but these conditions could quickly develop if the blood pressure isn’t quickly brought under control.7
Untreated hypertension causes serious complications, including organ damage. Less commonly, a condition called hypertensive emergency, which may also be called hypertensive crisis or malignant hypertension can occur.
A hypertensive emergency, unlike the similar sounding hypertensive urgency, is characterized by serious, life-threatening complications. A hypertensive emergency means that the blood pressure is >180 mm Hg or the diastolic pressure is >120 mm Hg, and that end-organ damage is occurring. Signs and symptoms can include shortness of breath, anxiety, chest pain, irregular heart rate, confusion, or fainting.8
An aneurysm, which is a bulge in the wall of an artery, can form due to a number of causes. Aneurysms can occur in the aorta, brain, and kidneys. Hypertension contributes to aneurysm formation, and sudden elevations of blood pressure can increase the risk of an aneurysm rupture—a serious event that can be fatal.9
Hypertension increases the risk of vascular disease, characterized by atherosclerosis (hardening and stiffening of the blood vessels) and narrowing of the arteries. Vascular disease can involve the blood vessels in the legs, heart, brain, kidneys, and eyes, causing a range of disabling or life-threatening symptoms.
Hypertension contributes to the development and worsening of coronary artery disease, cardiac arrhythmias, and heart failure.10
Hypertension can affect the kidneys, as their blood vessels become less able to function effectively; permanent damage is possible.
Respiratory disease can develop as a consequence of heart disease, manifesting as shortness of breath with exertion.
When to See a Doctor
It is important to go to your regular check-ups with your doctor. Hypertension is a common condition and, if caught, can be treated with medication to prevent complications.
However, if you experience any of the symptoms of hypertension, such as frequent headaches, recurrent dizziness, nosebleeds, shortness of breath, nausea or vomiting, don’t wait—speak to your doctor immediately.
Hypertension requires regular visits with your doctor to monitor your progress. If you are already on blood pressure medication and experience any related side effects, contact your doctor to see if your regimen needs to be adjusted.
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When to Go to the Hospital
A hypertensive emergency requires immediate emergency medical care.
The symptoms of a hypertensive emergency include:
- Severe headaches
- Chest pain
- Shortness of breath
- Severe dizziness or feeling faint
- Vision changes
- Weakness, numbness, tingling in the arms, legs, or face on one of both sides
- Trouble speaking or understanding words
- Confusion or behavioral changes
Do not attempt to lower extremely elevated blood pressure in yourself or someone else.11 While the goal is to reduce blood pressure before additional complications develop, blood pressure should be reduced over the course of hours to days, depending on severity. It is important not to lower blood pressure too quickly, because rapid blood pressure reductions can cut off the supply of blood to the brain, leading to brain damage or death.