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High blood pressure usually causes no symptoms and high blood pressure often is labeled “the silent killer.” People who have high blood pressure typically don’t know it until their blood pressure is measured.

Sometimes people with markedly elevated blood pressure may develop:

1.Chest pain and shortness of breath.
2.Nausea and vomiting.
3.Blurred vision.
4.Dizziness.
5.Headache.

People often do not seek medical care until they have symptoms arising from the organ damage caused by chronic (ongoing, long-term) high blood pressure. The following types of organ damage are commonly seen in chronic high blood pressure:

1.Outpouchings of the aorta, called aneurysms
2.Peripheral arterial disease causing leg pain with walking (claudication)
3.Eye damage with progressive vision loss
4.Kidney failure
5.Stroke or transient ischemic attack (TIA)
6.Heart failure
7.Heart attack

About 1% of people with high blood pressure do not seek medical care until the high blood pressure is very severe, a condition known as malignant hypertension.

1.Malignant hypertension requires emergency intervention and lowering of blood pressure to prevent brain hemorrhage or stroke.
2.Malignant hypertension may be associated with headache, lightheadedness, nausea, vomiting, and stroke like symptoms
3.In malignant hypertension, the diastolic blood pressure (the lower number) often exceeds 140 mm Hg.

It is of utmost importance to realize that high blood pressure can be unrecognized for years, causing no symptoms but causing progressive damage to the heart, other organs, and blood vessels.

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.

Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don’t occur until high blood pressure has reached a severe even life threatening stage.

Uncomplicated high blood pressure usually occurs without any symptoms (silently) and so hypertension has been labeled “the silent killer.” It is called this because the disease can progress to finally develop any one or more of the several potentially fatal complications of hypertension such as heart attacks or strokes. Uncomplicated hypertension may be present and remain unnoticed for many years, or even decades. This happens when there are no symptoms, and those affected fail to undergo periodic blood pressure screening.

Some people with uncomplicated hypertension, however, may experience symptoms such as headache, dizziness, shortness of breath, and blurred vision. The presence of symptoms can be a good thing in that they can prompt people to consult a doctor for treatment and make them more compliant in taking their medications. Often, however, a person’s first contact with a physician may be after significant damage to the end-organs has occurred. In many cases, a person visits or is brought to the doctor or an emergency room with a heart attack, stroke, kidney failure, or impaired vision (due to damage to the back part of the retina). Greater public awareness and frequent blood pressure screening may help to identify patients with undiagnosed high blood pressure before significant complications have developed.

About one out of every 100 (1%) people with hypertension is diagnosed with severe high blood pressure (accelerated or malignant hypertension) at their first visit to the doctor. In these patients, the diastolic blood pressure (the minimum pressure) exceeds 140 mm Hg! Affected persons often experience severe headache, nausea, visual symptoms, dizziness, and sometimes kidney failure. Malignant hypertension is a medical emergency and requires urgent treatment to prevent a stroke (brain damage).