Heart Health High Blood Pressure Living With Hypertension Guide Hypertension Guide Overview Symptoms Causes Diagnosis Treatment Coping 9 High Blood Pressure (Hypertension) Symptoms High blood pressure often doesn't cause symptoms, but here's what to watch for By Craig O. Weber, MD Updated on November 12, 2023 Medically reviewed by Anthony Pearson, MD Print Table of Contents View All Table of Contents Symptoms Rare Symptoms When to Get Help Next in Hypertension Guide What Causes High Blood Pressure (HBP)? When hypertension symptoms are present, they include dizziness, shortness of breath, headaches, and nosebleeds. But often, these and other symptoms of high blood pressure are often absent entirely. A hypertensive crisis, which is an uncommon and dangerous event, may cause blurry vision, nausea, vomiting, chest pain, and anxiety. If you develop any of these symptoms, you need to get immediate medical attention. This article explains the symptoms of hypertension and hypertensive emergencies. It also discusses when to see a healthcare provider. Verywell Illustration Hypertension Symptoms Hypertension symptoms are absent in the vast majority of people living with the condition. It is usually diagnosed in a healthcare provider'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, hypertension symptoms can happen at any time, do not last for long, and may recur. They include: Recurrent Headaches Headaches are fairly common, 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 severe, and can be of a throbbing nature. Hypertensive headaches commonly occur in the early morning. Dizziness Dizziness can be a side effect of most hypertension medications, including: Beta-blockers, such as bisopropolol Diuretics, such as hydrochlorothiazide ACE inhibitors, such as benzepril, lisinopril, and ramipril Angiotensin II receptor blockers, such as losartan and valsartan Calcium channel blockers, such as amlodipine Dizziness can also be caused by high blood pressure, but it should never be ignored. If dizziness occurs suddenly or causes loss of balance or coordination, call 911 or get to the nearest hospital right away. Dizziness due to hypertension can be a sign of stroke. Can Dizziness Be a Symptom of High Blood Pressure? Shortness of Breath Shortness of breath is the most common symptom of pulmonary hypertension, in which there is high blood pressure in the blood vessels that connect the heart to the lungs. In people with pulmonary hypertension, the arteries in the lungs are narrowed or blocked. This makes it difficult for the body to transport oxygenated blood into the left side of the heart then to the rest of the body. Shortness of breath due to hypertension is more noticeable with physical exertion, such as climbing stairs or other brief forms of physical activity. Fatigue or Weakness Fatigue and weakness are common side effects of pulmonary hypertension, affecting 57% of people with the condition. This side effect may manifest as physical fatigue, mental fatigue, reduced motivation, or some combination of them. Some conditions that are associated with hypertension, like stress and obstructive sleep apnea, can lead to fatigue, as can many hypertension medications. Can High Blood Pressure Make You Tired? Hypertensive Crisis Symptoms Hypertensive crisis is defined as systolic pressure of >180 mmHg and/or a diastolic pressure of >120 mmHg. It is the most severe form of hypertension, in which blood pressure spikes high enough to cause life-threatening complications like organ damage or stroke. The following symptoms of hypertensive crisis should never be ignored. If you develop any of them, call 911 or seek immediate medical attention. Severe Headache Severe headache is the most common symptom of hypertensive crisis, striking about 75% of people who experience the condition. A headache caused by a hypertensive crisis is typically described as a tension-type or throbbing sensation that wraps around the head rather than affecting one side. Keep in mind that a severe headache can be a warning sign of a stroke. In some cases, a headache develops days or up to a week before the stroke. But most of the time, the headache develops in under 60 seconds. Stroke survivors often call it the worst headache of their life. Thunderclap Headache Chest Pain Chest pain (angina) occurs in about 48% of people experiencing hypertensive crisis. This occurs when the heart does not get enough blood. The pain may feel like pressure or a squeezing sensation in the chest. Some describe it as the chest feeling full. It is typically located in the center or left side of the chest and may be mild or severe. Vertigo Vertigo occurs in about 44% of people experiencing hypertensive crisis. Vertigo is a sensation of being in motion despite being still. With vertigo, you may feel as though you are moving or spinning, or as though the world is spinning. Sometimes, vertigo is the only symptom of uncontrolled hypertension. Nausea and Vomiting About 42% of people experiencing hypertensive crisis develop nausea or vomiting. As blood pressure builds in the vessels of your brain, the increased pressure can trigger nausea. Sudden nausea or vomiting may also be a sign of stroke or heart attack. Shortness of Breath Almost 39% of people experiencing hypertensive experience shortness of breath. Elevated blood pressure makes it difficult for blood to bring oxygen to the heart and lungs, making it difficult to engage in even the lightest daily activities. Like other symptoms of hypertensive crisis, shortness of breath should be taken seriously and treated promptly to ensure your organs are getting enough oxygen. Nosebleed Hypertension may damage blood vessels in the nasal passages, eventually leading to nosebleeds. Approximately 33 out of every 10,000 people experience nosebleeds related to hypertension, according to a study in JAMA Otolaryngology-Head & Neck Surgery. This symptom is uncommon, and more likely to occur when hypertension is severe. Vision Changes Chronic hypertension can lead to a condition called hypertensive retinopathy, in which the blood vessels that supply the retina become damaged. The retina is a layer of tissue at the back of the eye that works with the brain to interpret light and imagery. Hypertensive retinopathy can lead to blurry vision, double vision, dim vision, and temporary or permanent vision loss. It can develop gradually over time in people with chronic, uncontrolled hypertension. Or, although rare, it can develop rapidly during a hypertensive crisis. Sudden vision changes should always be treated as an immediate medical emergency, as this is a major warning sign of stroke. Vision Changes Caused by Stroke When to See a Healthcare Provider Living with hypertension requires regular visits with your healthcare provider to monitor your progress. If you are already on blood pressure medication and experience any related side effects, contact your healthcare provider to see if your treatment plan needs to be adjusted. 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—see a healthcare provider right away. If you develop any symptoms of hypertension suddenly or if the symptoms seem especially severe or unusual, do not hesitate to call 911 or get to the nearest emergency medical center. Hypertension Doctor Discussion Guide Get our printable guide for your next healthcare provider's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Email Address Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. Readings for Stages 1–3 of Hypertension Summary Most people with hypertension do not develop symptoms unless the hypertension becomes severe or complications develop. This makes it all the more important to check your blood pressure regularly. When symptoms develop, they may include headaches, shortness of breath, fatigue, chest pain, vertigo, and vision changes. These symptoms can also be a sign of hypertensive crisis, which can lead to life-threatening organ damage unless treated promptly. Many of these symptoms can be a sign of stroke or heart attack, too. If you develop any new, unusual, or severe symptoms of hypertension, get immediate medical attention. 16 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Heart Association. What are the symptoms of high blood pressure?. Salkic S, Batic-mujanovic O, Ljuca F, Brkic S. Clinical presentation of hypertensive crises in emergency medical services. Mater Sociomed. 2014;26(1):12-6. doi:10.5455/msm.2014.26.12-16 World Health Organization. Hypertension. Courand PY, Serraille M, Girerd N, et al. The paradoxical significance of headache in hypertension. Am J Hypertens. 2016;29(9):1109-16. doi:10.1093/ajh/hpw041 Mohammadi M, Ayoobi F, Khalili P, Soltani N, La Vecchia C, Vakilian A. Relation of hypertension with episodic primary headaches and chronic primary headaches in population of Rafsanjan cohort study. Sci Rep. 2021 Dec;11(1):24071. doi:10.1038/s41598-021-03377-7 American Heart Association. Types of blood pressure medications. Michigan Medicine. Why does pulmonary hypertension cause shortness of breath?. Tartavoulle T, Karpinski A, Aubin A, Kluger B, Distler O, Saketkoo L. Multidimensional fatigue in pulmonary hypertension: prevalence, severity, and predictors. ERJ Open Res. 2018 Jan;4(1):00079-2017. doi:10.1183/23120541.00079-2017 American Heart Association. Understanding blood pressure readings. Salkic S, Batic-Mujanovic O, Ljuca F, Brkic S. Clinical presentation of hypertensive crisis in emergency medical services. Mater Sociomed. 2014 Feb;26(1):12-16. doi:10.5455/msm.2014.26.12-16 Cedars Sinai. Thunderclap headache: Every second counts in brain emergencies. National Heart, Lung, and Blood Institute. Living with high blood pressure. Penn Medicine. Vertigo. Osuji A. The interaction of hypertension for vertigo in audiovestibular medicine clinic. Res Vestib Sci. 2022 Jun;21(2):29-39. doi:10.21790/rvs.2022.21.2.29 Byun H, Chung JH, Lee SH. Association of hypertension with the risk and severity of epistaxis. JAMA Otolaryngol Head Neck Surg. 2021;147(1):34-40. doi:10.1001/jamaoto.2020.2906 Mount Sinai. High blood pressure and eye disease. Additional Reading Di Nicolò P. The dark side of the kidney in cardio-renal syndrome: renal venous hypertension and congestive kidney failure. Heart Fail Rev. 2018 Mar;23(2):291-302. doi: 10.1007/s10741-018-9673-4. By Craig O. Weber, MD Craig O. 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