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Hypertension symptoms: What are the early signs of hypertension?

Medically reviewed by Anne Jacobson, MD, MPH
Board-Certified Family Physician
Updated Oct. 27, 2023  •  Published Apr. 3, 2023
Fact Checked
Hypertension symptoms

Overview: What does hypertension feel like?

High blood pressure, or hypertension, is sometimes called the “silent killer.” That’s because many people with hypertension have no symptoms or signs until high blood pressure has damaged the body. High blood pressure is usually discovered at a routine blood pressure check or clinic visit. Healthcare professionals diagnose hypertension when the pressure in the arteries goes above 130 mm Hg (millimeters of mercury) when the heart beats (systolic pressure) or sits above 80 mm Hg when the heart is at rest (diastolic pressure). This blood pressure is commonly read as 130/80. When there are symptoms, it’s usually because blood pressure is so high that it’s rapidly damaging the body’s organs or causing fluid to leak into the brain. This is called a hypertensive crisis, and the symptoms may include nosebleeds, headaches, blurred vision, confusion, shortness of breath, and other problems. These are all signs that emergency medical treatment is needed.

 RELATED: Understanding blood pressure levels

Key takeaways:

  • Hypertension is a common health condition that can affect anyone, regardless of age, sex, race, or ethnicity. Find updated hypertension statistics here.

  • Hypertension does not have early signs.

  • Serious symptoms of hypertension, such as headaches, blurred vision, confusion, nausea, vomiting, anxiety, and seizures, may require immediate medical attention.

  • Hypertension usually does not have an identifiable cause. When it does, it is usually caused by kidney disease, hormone disorders, blood vessel disorders, obstructive sleep apnea, pre-eclampsia, or drugs. You may be at risk for developing hypertension symptoms if you are pregnant, have certain chronic diseases, or have a family history of high blood pressure. Other risk factors include smoking, an unhealthy diet, physical inactivity, high salt intake, and obesity.

  • Hypertension requires a medical diagnosis.

  • Hypertension generally requires treatment. If hypertension symptoms are present, they typically resolve with treatment within a few days or weeks, but it may take longer for other people.

  • Treatment of hypertension may include blood pressure medications and lifestyle changes. Read more about hypertension treatments here.

  • Untreated hypertension could result in complications like atherosclerosis, coronary artery disease, heart disease, heart attack, stroke, kidney damage, kidney failure, atrial fibrillation, or death.

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What are the early signs of hypertension?

Most people do not know they have a blood pressure problem until it’s discovered during a routine screening. When people do report symptoms, they may be related to other problems. 

Other hypertension symptoms

However, if blood pressure gets so high or lasts for so long that it starts to damage the body’s organs, symptoms will appear. When blood pressure gets very high, it’s called a “hypertensive emergency” or “hypertensive crisis.” About one in five people in a hypertensive crisis will have nosebleeds. Other symptoms of a hypertensive crisis are caused by tissue damage. This requires immediate medical care.

Early symptoms of organ damage due to severely high blood pressure include:

  • Shortness of breath

  • Chest pain

  • Reduced urination

  • Difficulty breathing

Extremely high blood pressure can also cause fluid to build up in the brain. This event is called hypertensive encephalopathy, and the most common symptoms are:

  • Headaches

  • Dizziness

  • Confusion

  • Nausea

  • Vomiting

  • Blurred vision

Other symptoms of fluid buildup in the brain include:

  • Loss of vision

  • Tingling or numbness

  • Seizures

What are the early signs of hypertension?

RELATED: What happens when your blood pressure is too low?

Stages of hypertension: How can I tell which one I have? 

Since hypertension typically has no symptoms, it’s not always possible to tell how bad it is. That’s why it’s important to have your blood pressure checked regularly, so it can be treated before it starts damaging the body.

The American College of Cardiology guidelines for staging hypertension are as follows:

  • Normal blood pressure is 120/80 mm Hg or less

  • Elevated blood pressure is diagnosed when the systolic pressure is between 120 and 129 mm Hg, and diastolic pressure is below 80 mm Hg

  • Stage I hypertension is diagnosed when systolic pressure is between 130 and 139 mm Hg and diastolic blood pressure between 80 and 89 mm Hg

  • Stage 2 hypertension is diagnosed when systolic blood pressure equals or exceeds 140 mm Hg, and diastolic blood pressure equals or exceeds 90 mm Hg

  • A hypertensive crisis occurs when blood pressure readings are 180/110 mm Hg or higher.

Blood pressure fluctuates throughout the day and in different situations. Often, more than one blood pressure reading is needed to diagnose hypertension. Additionally, blood pressure increases for some people when they are in a doctor’s office or healthcare clinic, a phenomenon called “white coat” hypertension. The American College of Cardiology suggests that healthcare providers wait to make a diagnosis in some cases until patients take their blood pressure readings at home, once during the day and once at night. This will give a more complete picture of overall blood pressure health. And the International Society of Hypertension suggests that hypertension be diagnosed when blood pressure is above 140/90 mm Hg rather than 130/80 mm Hg. 

RELATED: What is white coat hypertension?

When to see a doctor for hypertension symptoms

Because hypertension typically has no symptoms until it starts to cause injury, it’s important to have regular checkups, physicals, and blood pressure checks. The good news is that nearly every time a healthcare provider is seen, someone will check blood pressure. If it’s too high, it won’t be ignored.

Emergency medical treatment is needed if there are symptoms of severe hypertension such as headache, blurred vision, shortness of breath, or chest pain. 

If blood pressure readings are high on two or more occasions, a diagnosis of hypertension is likely. A medical history and physical will be performed to determine if there’s an underlying cause.

Complications of hypertension

According to the ACC guidelines, the most concerning complication of high blood pressure is atherosclerotic cardiovascular disease (ASCVD), which is cholesterol and fat plaque buildup on artery walls. ASCVD is a serious health problem that can result in complications such as:

  • Coronary artery disease (blockage of blood flow to the heart)

  • Angina (pain caused by lack of oxygen to the heart)

  • Heart attack

  • Stroke

  • Peripheral artery disease

  • Death

Other complications of hypertension include:

How to treat hypertension symptoms

High blood pressure requires treatment. The standard treatment for hypertension involves lifestyle changes and drugs that lower blood pressure. 

According to the ACC, lifestyle changes that dramatically affect blood pressure include:

The most commonly used blood pressure drugs for people first diagnosed with high blood pressure are angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), and thiazide diuretics. Other common antihypertensives include beta blockers, alpha blockers, diuretics, and central agonists. These drugs are normally taken by mouth once per day. Some may be taken more than once per day.

Living with hypertension

Hypertension is treatable. Many people will successfully hit their target blood pressure if they do the following:

  • Take prescribed blood pressure medications as instructed

  • Do not skip doses of medication

  • Learn how to correctly measure your blood pressure using a home blood pressure monitor

  • Monitor blood pressure regularly to make sure treatment is working—talk to your healthcare provider if blood pressure goals are not being met

  • Keep a record of medication side effects and share it with your healthcare provider

  • Maintain a healthy weight

  • Exercise

  • Eat a heart-healthy diet

  • Reduce sodium intake

  • Increase potassium intake

  • Reduce alcohol consumption

  • Reduce caffeine intake

  • Stop smoking

  • Avoid illicit drugs

  • Avoid over-the-counter drugs that raise blood pressure such as decongestants, nonsteroidal anti-inflammatory drugs (NSAIDs), and combination cold/flu medications

RELATED: The best diet for your blood pressure—14 foods to eat, and 8 to avoid

Most importantly, make some important changes in your life

According to the ACC, some lifestyle changes will lower blood pressure by at least 5 mm Hg, including weight loss, healthy eating, regular physical activity, reduced sodium intake, increased potassium intake, and moderating or avoiding alcohol. Lifestyle changes can be difficult, and most people need to try them a number of times before they become a habit. However, lifestyle changes will also help with blood sugar, cholesterol levels, healthy weight, and other health conditions. The only side effects of a healthy lifestyle are feeling better and being healthier. 

FAQs about hypertension symptoms

What are the silent symptoms of hypertension?

Symptoms of high blood pressure are “silent” because there are typically no symptoms. Unless blood pressure is extremely high, it typically can’t be felt or seen. But it can still cause damage to the body over time. Hypertension is diagnosed with blood pressure measurements. 

Are skin problems a sign of hypertension?

Skin problems are not signs of hypertension. There may be relationships between hypertension and certain skin problems, but these are just correlations. The only way to know your blood pressure is to measure it with a blood pressure monitor.

Does hypertension cause blurry vision?

Hypertension does not usually cause blurry vision unless it is extremely high. However, over time, untreated high blood pressure can damage the retina or optic nerve. According to the American Heart Association (AHA), this damage to the eye can lead to gradual vision loss. Extremely high blood pressure can cause fluid to leak into the brain and cause swelling. The most common symptoms of this are headaches, confusion, dizziness, and blurred vision.

What’s next? Additional resources for people with hypertension symptoms

Test and diagnostics

Treatments

Scientific studies and clinical trials

Medically reviewed by Anne Jacobson, MD, MPH
Board-Certified Family Physician

Anne Jacobson, MD, MPH, is a board-certified family physician, writer, editor, teacher, and consultant. She is a graduate of University of Wisconsin School of Medicine and Public Health, and trained at West Suburban Family Medicine in Oak Park, Illinois. She later completed a fellowship in community medicine at PCC Community Wellness and a master's in Public Health at the University of Illinois-Chicago. She lives with her family near Chicago.

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