Blood pressure is known as the "silent killer" because most people with hypertension experience no symptoms. As a result, the condition may go undetected unless you visit your doctor regularly to have your blood pressure measured. In some people with very elevated levels, symptoms such as headaches may occur—typically a dull pain in the back of the head on waking in the morning.
Sometimes, hypertension is first detected when one of the following complications of high blood pressure occurs:
• Stroke or transient ischemic attack (TIA), also known as a mini-stroke
• Heart problems like chest pain, heart attack, or heart failure
• Peripheral arterial disease (blockages of blood vessels in the legs that cause pain in the leg muscles with physical activity)
• Kidney disease
• Vision problems, such as blurring
A hypertensive crisis, when blood pressure reaches very high levels, is another situation in which symptoms can arise. Fortunately, it is uncommon, occurring in less than 1 percent of people with hypertension.
People who abruptly stop their blood pressure medication are at risk. Symptoms of a hypertensive crisis include headache, nosebleed, chest pain, shortness of breath, seizures, back pain, confusion, blurred vision, nausea, and vomiting. When a hypertensive crisis is suspected, call for an ambulance immediately.
High blood pressure can take a toll on your health. It can damage large and small arteries, leading to strokes and diseases of the heart, kidneys and eyes. It may even affect your sexual function, as healthy blood vessels and sufficient blood flow are a crucial part of sexual arousal. Fortunately, keeping blood pressure under control can help prevent or slow the progression of these conditions:
• Strokes. Hypertension accelerates atherosclerosis, the buildup of plaques within the walls of the large arteries. It places added pressure on the artery walls and damages the tissues within the arteries, making them more susceptible to plaque accumulation.
When these plaques partially obstruct blood flow in an artery that carries blood to the brain, they can trigger a transient ischemic attack (TIA), a mini-stroke that causes symptoms such as slurred speech or weakness on one side of the body that usually disappear within an hour. If a blood clot forms in a plaque-containing artery that leads to the brain, it could completely block blood flow and cause a full-blown ischemic stroke. Hypertension can also weaken arteries, resulting in a saclike bulge, called an aneurysm, in the artery’s wall. If an aneurysm ruptures in an artery supplying blood to the brain, it can result in a hemorrhagic (bleeding) stroke.
• Heart disease. Over time, plaques can build up in the coronary arteries that carry blood to the heart, interfering with blood flow and increasing the risk of angina (chest pain). If a coronary artery becomes completely blocked, a heart attack occurs and can lead to cardiac arrest and death. Hypertension also causes the heart to work harder to pump against the higher pressures in the arteries. This excess workload thickens and increases the size of the heart’s muscle and increases the risk of heart attack, heart failure, and cardiac arrest.
• Kidney disease. Hypertension can damage your kidneys in two ways. First, high blood pressure promotes plaque buildup in the main arteries that supply blood to the kidneys. Second, elevated blood pressure damages the small arteries within the kidneys itself. Both situations can lead to gradual worsening of kidney function and, eventually, kidney failure.
• Eye disease. Chronic high blood pressure can damage the tiny arteries that carry blood to the retina—the light-sensitive nerve tissue in the back of the eye that enable you to see. This results in a condition called hypertensive retinopathy. In the early stages, the retinal arteries thicken and the space through which blood flows narrows. Eventually, these blood vessels develop blockages or begin to leak blood and fluid. In severe cases, the optic nerve, which carries visual impulses to the brain, swells and causes vision loss. Hypertensive retinopathy typically develops slowly, and many years pass before changes in vision appear.