What are the Symptoms of High Blood Pressure?
Don't fall for the symptoms myth
The myth of symptoms
There's a common misconception that people with high blood pressure, also called hypertension, will experience symptoms such as nervousness, sweating, difficulty sleeping or facial flushing. The truth is that HBP is largely a symptomless condition. If you ignore your blood pressure because you think symptoms will alert you to the problem, you are taking a dangerous chance with your life. Everybody needs to know their blood pressure numbers, and everyone needs to prevent high blood pressure from developing.
The myth of symptomatic headaches
The best evidence indicates that high blood pressure does not cause headaches except perhaps in the case of hypertensive crisis (systolic/top number higher than 180 OR diastolic/bottom number higher than 110).
In the early 1900s, it was assumed that headaches were more common among people with high blood pressure. However, research into the subject doesn't support this view. According to one study, people with high blood pressure seem to have significantly fewer headaches than the general population.
In a study published in the journal Neurology, people with higher systolic blood pressure (the top number in blood pressure readings) were up to 40 percent less likely to have headaches compared to those with healthier blood pressure readings. The researchers also looked at another measurement called the pulse pressure, which is the change in blood pressure when the heart contracts. Pulse pressure is calculated by subtracting the bottom number (diastolic reading) from the top number (systolic reading). Those with higher pulse pressure had up to 50 percent fewer headaches. The researchers think that the higher the pulse pressure, the stiffer the blood vessels. The stiffer the blood vessel, the less likely the nerve endings are working properly. If the nerve endings aren't functioning correctly, the less likely a person will feel pain.
Therefore, headaches or the lack of headaches are not reliable indicators of your blood pressure. Instead, work with your doctor and know your numbers.
The myth of symptomatic nosebleeds
Except with hypertensive crisis, nosebleeds are not a reliable indicator for HBP. In one study, 17 percent of people treated for high blood pressure emergencies at the hospital had nosebleeds. However, 83 percent reported no such symptom. Although it's also been noted that some people in the early stages of high blood pressure may have more nosebleeds than usual, there are other possible explanations. If your nosebleeds are frequent (more than once a week) or if they are heavy or hard to stop, you should talk to your healthcare professional.
Keep in mind that nosebleeds can be caused by a variety of factors, with the most common one being dry air. The lining of the nose contains many tiny blood vessels that can bleed easily. In a hot climate like the desert Southwest or with heated indoor air, the nasal membranes can dry out and make the nose more susceptible to bleeding. Other causes include vigorously blowing your nose; medical conditions like allergies, colds, sinusitis or a deviated septum; and side effects from some anticoagulant drugs like warfarin or aspirin.
Other inconclusively related symptoms
You should not try to evaluate your symptoms in an attempt to self-diagnose high blood pressure. Diagnosis should only be made by a healthcare professional. A variety of symptoms may be indirectly related to HBP but are not always caused by HBP, such as:
Yes, blood spots in the eyes, or subconjunctival hemorrhage, are more common in people with diabetes or high blood pressure, but neither condition causes the blood spots. Floaters in the eyes are not related to high blood pressure. However, an ophthalmologist may be able to detect damage to the optic nerve caused by untreated HBP.
Facial flushing occurs when blood vessels in the face dilate. The red, burning face can occur unpredictably or in response to certain triggers such as sun exposure, cold weather, spicy foods, wind, hot drinks and skin-care products. Facial flushing can also occur with emotional stress, exposure to heat or hot water, alcohol consumption and exercise, all of which can raise blood pressure temporarily. While facial flushing may occur while your blood pressure is higher than usual, HBP is not the cause of facial flushing.
Although it is not caused by HBP, dizziness can be a side effect of some high blood pressure medications. Nonetheless, dizziness should not be ignored, especially if you notice a sudden onset. Sudden dizziness, loss of balance or coordination and trouble walking are all warning signs of a stroke. HBP is one of the leading risk factors for stroke.
As mentioned above, only when blood pressure readings soar to dangerously high levels (systolic of 180 or higher OR diastolic of 110 or higher) may obvious symptoms occur. Blood pressure this high is known as hypertensive crisis, and emergency medical treatment is needed.
Hypertensive crises can present as hypertensive urgency or as a hypertensive emergency.
Hypertensive urgency is a situation where the blood pressure is severely elevated [180 or higher for your systolic pressure (top number) or 110 or higher for your diastolic pressure (bottom number)], but there is no associated organ damage. Those experiencing hypertensive urgency may or may not experience one or more of these symptoms:
- Severe headache
- Shortness of breath
- Severe anxiety
Treatment of hypertensive urgency generally requires readjustment and/or additional dosing of oral medications, but most often does not necessitate hospitalization for rapid blood pressure reduction. A blood pressure reading of 180/110 or greater requires immediate evaluation, because early evaluation of organ function and blood pressure elevations at these levels is critical to determine the appropriate management.
A hypertensive emergency exists when blood pressure reaches levels that are damaging organs. Hypertensive emergencies generally occur at blood pressure levels exceeding 180 systolic OR 120 diastolic, but can occur at even lower levels in patients whose blood pressure had not been previously high.
The consequences of uncontrolled blood pressure in this range can be severe and include
If you get a blood pressure reading of 180 or higher on top or 110 or higher on the bottom, and are having any symptoms of possible organ damage (chest pain, shortness of breath, back pain, numbness/weakness, change in vision, difficulty speaking) do not wait to see if your pressure comes down on its own. Seek emergency medical assistance immediately. If you can't access the emergency medical services (EMS), have someone drive you to the hospital right away.
- Loss of consciousness
- Memory loss
- Heart attack
- Damage to the eyes and kidneys
- Loss of kidney function
- Aortic dissection
- Angina (unstable chest pain)
- Pulmonary edema (fluid backup in the lungs)
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