9 High Blood Pressure (Hypertension) Symptoms

High blood pressure often doesn't cause symptoms, but here's what to watch for

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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.

hypertension symptoms

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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:

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.

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.

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.

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.

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.

Doctor Discussion Guide Old Man

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.
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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. Weber, MD, is a board-certified occupational specialist who has practiced for over 36 years.