Signs of high blood pressure

What are signs of high blood pressure?

Signs of high blood pressure are the observable manifestations of high blood pressure, also known by its medical name of hypertension or arterial hypertension.

High blood pressure occurs when the force of blood pressing against the artery walls is higher than normal. This puts extra strain on the heart and blood vessels, which in turn increases the risk of heart failure, heart attack, stroke and other serious conditions.[1][2]

High blood pressure is a common condition affecting roughly 46 percent of adults in the US. The condition is particularly common in older people, with roughly 82 percent of adults aged 75 and over experiencing the condition in the US.[2]

Lifestyle changes and medication can help to bring down high blood pressure and reduce the possibility of serious complications. However, if left unmanaged, these complications can lead to serious health issues, disability and/or can be life-threatening.

Signs of high blood pressure

High blood pressure typically causes no observable signs or symptoms. Often, the condition will go undetected until it is picked up by doctors during a routine blood pressure test, a routine general examination or as part of testing for another suspected condition. It may also go undiagnosed until a complication, such as frequent or severe headaches, frequent dizziness or even a major event – like a heart attack or stroke – occurs that leads a person to make a consultation with a doctor.

Signs of very high blood pressure

In cases where high blood pressure is severe, the following signs and symptoms may occur:[1][3][4]

  • Headaches, especially in the mornings and when waking up
  • Dizziness or confusion
  • Blurred vision
  • Tinnitus, a ringing our swishing sound in one or both ears
  • Nosebleeds
  • Fatigue, feeling tired and worn out all the time
  • Sleep disturbances
  • Nervousness
  • Flushed (facial) expression
  • Chest pain
  • Abnormal heartbeat

Signs of hypertensive crisis (acute severe hypertension)

A hypertensive crisis is defined by many doctors as a situation in which blood pressure rises very quickly (acutely) and readings measure 180 over 120 or greater. During a hypertensive crisis, signs of organ damage are also seen to become more severe, the longer this state of severely high blood pressure lasts.

If not treated promptly, it can lead to severe complications such as stroke, heart attack and loss of kidney function.[5]

A severely high blood pressure reading may be accompanied by the signs and symptoms mentioned in the section above, as well as additional symptoms such as:

  • Acutely occuring severe headaches
  • Acute shortness of breath
  • Anxiety or panic

A hypertensive crisis is a medical emergency requiring urgent treatment without delay.

Signs of high blood pressure in pregnancy

Similarly to people who are not pregnant, people with high blood pressure in pregnancy will typically display no signs or symptoms of the condition. For this reason, regular blood pressure tests are carried out during pregnancy in order to detect the condition if it occurs, as this can also be part of a complication of pregnancy called preeclampsia that requires urgent medical treatment.[1]

High blood pressure complications

In some cases, the complications of high blood pressure may be the first observable sign that a person is experiencing the condition.

Possible complications of high blood pressure include:[6][4]

  • Heart disease and coronary artery disease
  • Heart attack
  • Heart failure
  • Peripheral arterial disease
  • Aortic aneurysms
  • Atrial fibrillation, a heart rhythm condition
  • Kidney disease up to renal failure
  • Carotid artery stenosis
  • Vascular dementia or other cognitive changes such as memory difficulties
  • Stroke
  • Retina disease – damage to the retina, the part of the eye responsible for focussing images

Causes of high blood pressure

In 85 to 95 percent of people, it is difficult to identify a single cause of high blood pressure. This is called essential hypertension. Research indicates that essential hypertension is made more likely by factors including:[4]

  • Having diabetes type 1 or 2
  • Being of African, Caribbean or Indian descent
  • Having a family history of high blood pressure

The following lifestyle factors can also contribute to the development of high blood pressure. These include:[4]

  • Being overweight or obese
  • Eating too much salt and not enough potassium
  • Living a sedentary lifestyle
  • Drinking excessive amounts of alcohol
  • Smoking
  • Excessive caffeine intake
  • Being stressed

More rarely, high blood pressure can also be caused by separate conditions, most commonly certain kidney conditions and various hormone problems. This is called secondary hypertension.

High blood pressure diagnosis

Blood pressure readings are given as two numbers, for example 150 over 80. The first figure – the systolic level – reflects the pressure inside the arteries as blood is pumped out of the heart. The second figure – the diastolic level – reflects the pressure inside the arteries as the heart rests between beats.[1]

Sources differ over how high blood pressure should be defined. According to The Joint National Commission (JNC), a systolic level of over 140 mm Hg and/or a diastolic level of over 90 mm Hg indicates high blood pressure, while according to the American College of Cardiology, a reading of 130 and/or over 90 indicates high blood pressure.[2]

A diagnosis of high blood pressure can be made after a person takes at least two blood pressure tests at least one week apart, measured in both arms, and each measure equally high, or if the condition is observed in a long-term – typically 24 hours – measurement of blood pressure.

The anxiety of visiting a doctor can cause blood pressure to rise temporarily in some people, making multiple additional tests necessary. In some cases, a person may be asked to measure their own blood pressure at home using a portable blood pressure testing kit provided by the doctor or obtained from a pharmacy.

In rare cases, if extremely high blood pressure is detected, a diagnosis may be given after a single reading.

High blood pressure treatment

A combination of both lifestyle changes and medication can help to manage high blood pressure and reduce the chances of complications.

Doctors may advise lifestyle changes such as:[2]

  • Reducing salt consumption
  • Losing weight
  • Exercising and/or moving for at least 30 minutes per day, or more intense exercise at least three times a week. Before undertaking a new exercise regimen or any known exercises after having experienced or being diagnosed with a medical condition, all persons should first consult their doctor
  • Stopping smoking
  • Reducing alcohol intake
  • Reducing caffeine intake
  • Reducing stress levels by learning to meditate, learn and practice Yoga, Tai Chi or Chi Gong, autogenic training or learning another relaxation technique suited for the individual person

Medication is generally only prescribed to people with consistently high blood pressure, usually of around higher or equal to 140 over 90. Medications used to treat high blood pressure include diuretics, ACE inhibitors and beta blockers, among others. The type of medication chosen will depend on the person, and some people may be required to take more than one medication at once to lower their blood pressure to a non-dangerous level.[7]

High blood pressure prevention

Maintaining a healthy lifestyle is key to preventing high blood pressure. This should involve:[8]

  • Eating a healthy and varied diet
  • Maintaining a healthy weight
  • Exercising regularly
  • Not smoking
  • Limiting alcohol intake
  • Reducing caffeine intake
  • Reducing stress levels by learning to meditate, learn and practice Yoga, Tai Chi or Chi Gong, autogenic training or learning another relaxation technique suited for the individual person

As high blood pressure is often symptomless, people, especially once they are over the age of 35 or 40, should have their blood pressure checked regularly to ensure it is within the healthy range.

People with pre-existing conditions that make high blood pressure more likely, such as diabetes, should also take extra care to control their condition effectively by following the treatment plan outlined by doctors.

Signs of high blood pressure FAQs

Q: Do signs of high blood pressure differ in men and women?
A: While the signs of blood pressure in men and women are typically the same, men, generally, are at a higher risk of high blood pressure than women before menopause of the same age. Although the reasons for this are not fully clear, evidence suggests that androgens, such as testosterone, may play a significant role.[9]

  1. Patient. “High Blood Pressure.” September 21, 2017. Accessed June 6, 2018.

  2. UpToDate. “Patient education: High blood pressure in adults (Beyond the Basics).” November 21, 2017. Accessed June 6, 2018.

  3. Everyday Health. “Warning Signs of Hypertension.” November 18, 2009. Accessed June 6, 2018.

  4. Amboss. “Hypertension.” April 24, 2018. Accessed July 6, 2018.

  5. American Heart Association. “Hypertensive Crisis: When You Should Call 9-1-1 for High Blood Pressure.” November 13, 2017. Accessed July 6, 2018.

  6. NHS Choices. “High blood pressure (Hypertension).” June 15, 2017. Accessed June 6, 2018.

  7. UpToDate. “Patient education: High blood pressure treatment in adults (Beyond the Basics). April 9, 2018. Accessed June 6, 2018.

  8. CDC. “Preventing High Blood Pressure: Healthy Living Habits.” July 7, 2014. Accessed June 6, 2018.

  9. AHA Journals. “Gender Differences in the Regulation of Blood Pressure.” May 1, 2001. Accessed June 6, 2018.