From the Guidelines
Uncontrolled high blood pressure often produces no symptoms, but when symptoms do occur, they may include headaches, blurred vision, nosebleeds, shortness of breath, chest pain, dizziness, and fatigue, as noted in the 2024 ESC guidelines for the management of elevated blood pressure and hypertension 1.
Symptoms of Uncontrolled Blood Pressure
The symptoms of uncontrolled blood pressure can be subtle and may not always be present, which is why regular blood pressure monitoring is crucial. However, when blood pressure reaches severely elevated levels, symptoms may become more apparent.
- Headaches, particularly in the morning, can be a symptom of uncontrolled blood pressure, as the increased pressure can cause blood vessels in the brain to become inflamed and irritated.
- Blurred vision, nosebleeds, and shortness of breath can also occur due to the increased pressure on blood vessels and organs.
- Chest pain, dizziness, and fatigue are additional symptoms that may indicate uncontrolled blood pressure.
Importance of Regular Monitoring
Regular blood pressure monitoring is essential to detect uncontrolled hypertension, as most people with hypertension feel normal despite elevated readings. The 2018 American College of Cardiology/American Heart Association hypertension guideline emphasizes the importance of accurate office blood pressure measurements and home or ambulatory blood pressure readings to rule out the white coat effect 1.
Hypertensive Crisis
In cases of hypertensive crisis, where systolic blood pressure is above 180 or diastolic blood pressure is above 120, additional symptoms may include severe anxiety, confusion, seizures, and even unconsciousness. If you experience severe headaches, vision changes, chest pain, difficulty breathing, or blood in urine, seek immediate medical attention as these could indicate dangerously high blood pressure requiring urgent treatment.
Long-term Complications
Long-term uncontrolled hypertension can damage blood vessels and organs without noticeable symptoms, leading to serious complications like heart attack, stroke, kidney damage, and vision loss. The 2024 ESC guidelines highlight the importance of managing resistant hypertension, which is associated with a worse prognosis, including a two- to six-fold higher risk of myocardial infarction, stroke, end-stage renal disease, and death 1.
From the Research
Symptoms of Uncontrolled Blood Pressure
The provided studies do not directly address the symptoms of uncontrolled blood pressure. However, they discuss the importance of managing hypertension and the efficacy of various antihypertensive therapies.
Efficacy of Antihypertensive Therapies
- The study 2 highlights the efficacy of amlodipine, a dihydropyridine calcium channel blocker, in improving blood pressure and patient outcomes.
- The study 3 compares the efficacy of amlodipine plus valsartan with lisinopril plus hydrochlorothiazide in patients with stage 2 hypertension, finding both combinations to be well-tolerated and efficacious.
- The study 4 demonstrates the superiority of the benazepril-amlodipine combination over the benazepril-hydrochlorothiazide combination in reducing cardiovascular events in high-risk patients.
- The study 5 investigates the effects of different antihypertensive drug combinations on blood pressure and arterial stiffness, finding that various combinations are equally effective in reducing blood pressure and improving arterial stiffness.
- The study 6 compares the outcomes and adverse events between angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), finding no difference in efficacy but fewer adverse events with ARBs.