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. This and the potential severity of complications has given rise to hypertension's reputation as a "silent killer."

Hypertension can cause heart disease, stroke, and kidney failure when not adequately treated—in some cases before it's ever diagnosed. A hypertensive emergency, which is an uncommon and dangerous event, may cause blurry vision, nausea, chest pain, and anxiety.

This article explains both common are rare hypertension symptoms. It discusses serious health issues that can arise due to the condition, and why and when it may be important to see a healthcare provider.

Common 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.

hypertension symptoms

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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. 
  • 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. Shortness of breath is more noticeable with physical exertion or exercise. 
  • Nosebleed: You may be more prone to nosebleeds if you have high blood pressure although, in general, nosebleeds are not a classic sign of high blood pressure.

Rare Hypertension Symptoms 

Hypertension symptoms are more likely to occur with sudden and extremely high blood pressure than with chronic hypertension. However, it is important to know that even very high blood pressure may not produce symptoms. 

Severe high blood pressure is defined as systolic pressure of >180 mmHg or a diastolic pressure of >120 mmHg. People with severe high blood pressure can develop symptoms quickly, including: 

  • 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. 
  • 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). 
  • Nausea, vomiting or loss of appetite: Nausea associated with severe hypertension can develop suddenly and may be associated with dizziness.  

Hypertensive Urgency

A type of high blood pressure without serious symptoms is called hypertensive urgency. 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.

Hypertensive urgency is defined as a systolic blood pressure of greater than 180 mmHg and/or a diastolic blood pressure of >110 mmHg. This blood pressure is considered high enough to put you at serious risk of sudden, life-threatening events.

Complications of High Blood Pressure

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.

Hypertensive Emergency

A hypertensive emergency, unlike the similar sounding hypertensive urgency, is characterized by serious, life-threatening complications.

Signs and symptoms can include:

  • Shortness of breath
  • Anxiety
  • Chest pain
  • Irregular heart rate
  • Confusion
  • Fainting

A hypertensive emergency means that the systolic blood pressure is greater than 180 mmHg or the diastolic pressure is >120 mmHg, and that end-organ damage is occurring.

Aneurysm Rupture

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. 

Vascular Disease

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. 

High pressure impacts arterial wall contraction.

Heart Disease

Hypertension contributes to the development and worsening of coronary artery disease, cardiac arrhythmias, and heart failure

Kidney Failure

Hypertension can affect the kidneys, as their blood vessels become less able to function effectively; permanent damage is possible.

Respiratory Disease

Respiratory disease can develop as a consequence of heart disease, manifesting as shortness of breath with exertion. 

When to See a Healthcare Provider

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 healthcare provider immediately.

That said, it's important not to wait for symptoms to be checked out. Go to your regular physical exams with your healthcare provider. Hypertension is a common condition and, if caught, can be treated with medication to prevent complications.

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.

Who Is at Risk of Hypertension?

The risk of high blood pressure is influenced by a number of factors, including your age and gender as well as genetics. Lifestyle factors, such as smoking, diet, and exercise, also may contribute to its development. Underlying health conditions, such as diabetes or thyroid disease, increase the risk.

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
  • Palpitations
  • 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. 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.

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

Frequently Asked Questions

  • What defines hypertension?

    Hypertension is when the force of your blood against the walls of your vessels is regularly elevated. It is defined by a systolic pressure chronically greater than 130 millimeters of mercury (mmHg) or a diastolic pressure greater than 80 mmHg.

  • What happens if hypertension is left untreated?

    Over time, untreated high blood pressure can lead to more serious conditions, including damage to the heart, kidneys, and other organs. High blood pressure can also become life-threatening if an aneurysm, stroke, heart attack, or other high-risk complications occur. 

  • What time of day is blood pressure highest?

    Blood pressure typically rises in the morning and then fluctuates, often peaking at midday. It becomes lower in the evening and at night. The pattern may vary with the individual. If you check it at home, try to do so at the same times every day so the readings are consistent.

13 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.