High blood pressure (hypertension)
The myth of symptoms and signs of high blood pressure
There’s a common misconception that people with high blood pressure, also called HBP or hypertension, will experience symptoms such as nervousness, sweating, difficulty sleeping or facial flushing. The truth is that HBP is largely a symptomless condition. If you ignore your blood pressure because you think symptoms will alert you to the problem, you are taking a dangerous chance with your life. Everybody needs to know their blood pressure numbers, and everyone needs to prevent high blood pressure from developing.
The myth of symptomatic headaches
The best evidence indicates that high blood pressure does not cause headaches except perhaps in the case of hypertensive crisis (systolic/top number higher than 180 OR diastolic/bottom number higher than 110).
In a study published in the journal Neurology, people with higher systolic blood pressure (the top number in blood pressure readings) were up to 40 percent less likely to have headaches compared to those with healthier blood pressure readings. The researchers also looked at another measurement called the pulse pressure, which is the change in blood pressure when the heart contracts. Pulse pressure is calculated by subtracting the bottom number (diastolic reading) from the top number (systolic reading). Those with higher pulse pressure had up to 50 percent fewer headaches. The researchers think that the higher the pulse pressure, the stiffer the blood vessels. The stiffer the blood vessel, the less likely the nerve endings are working properly. If the nerve endings aren’t functioning correctly, the less likely a person will feel pain.
The myth of symptomatic nosebleeds
Except with hypertensive crisis, nosebleeds are not a reliable indicator for HBP. In one study, 17 percent of people treated for high blood pressure emergencies at the hospital had nosebleeds. However, 83 percent reported no such symptom. Although it’s also been noted that some people in the early stages of high blood pressure may have more nosebleeds than usual, there are other possible explanations. If your nosebleeds are frequent (more than once a week) or if they are heavy or hard to stop, you should talk to your healthcare professional.
Keep in mind that nosebleeds can be caused by a variety of factors, with the most common one being dry air. The lining of the nose contains many tiny blood vessels that can bleed easily. In a hot climate like the desert Southwest or with heated indoor air, the nasal membranes can dry out and make the nose more susceptible to bleeding. Other causes include vigorously blowing your nose; medical conditions like allergies, colds, sinusitis or a deviated septum; and side effects from some anticoagulant drugs like warfarin (Coumadin®) or aspirin.
Other inconclusively related symptoms
You should not try to evaluate your symptoms in an attempt to self-diagnose high blood pressure. Diagnosis should only be made by a healthcare professional. A variety of symptoms may be indirectly related to HBP but are not always caused by HBP, such as:
- Blood spots in the eyes
Yes, blood spots in the eyes, or subconjunctival hemorrhage, are more common in people with diabetes or high blood pressure, but neither condition causes the blood spots. Floaters in the eyes are not related to high blood pressure. However, an ophthalmologist may be able to detect damage to the optic nerve caused by untreated HBP.
- Facial flushing
Facial flushing occurs when blood vessels in the face dilate. The red, burning face can occur unpredictably or in response to certain triggers such as sun exposure, cold weather, spicy foods, wind, hot drinks and skin-care products. Facial flushing can also occur with emotional stress, exposure to heat or hot water, alcohol consumption and exercise, all of which can raise blood pressure temporarily. While facial flushing may occur while your blood pressure is higher than usual, HBP is not the cause of facial flushing.
Although it is not caused by HBP, dizziness can be a side effect of some high blood pressure medications. Nonetheless, dizziness should not be ignored, especially if you notice a sudden onset. Sudden dizziness, loss of balance or coordination and trouble walking are all warning signs of a stroke. HBP is one of the leading risk factors for stroke.
The Symptoms of Hypertensive Crisis
As mentioned above, only when blood pressure readings soar to dangerously high levels (systolic of 180 or higher OR diastolic of 110 or higher) may obvious symptoms occur. Blood pressure this high is known as hypertensive crisis, and emergency medical treatment is needed.
In addition to extreme readings, a person in hypertensive crisis may experience:
- Severe headaches
- Severe anxiety
- Shortness of breath