Hypertension Symptoms
Most patients with hypertension are asymptomatic, which is why hypertension is often called the "silent killer." 1
Common Symptoms When Present
When symptoms do occur in hypertensive patients, they typically include:
- Headaches 1
- Blurred vision 1
- Dizziness 1
- Chest pain 1
- Shortness of breath 1
- Palpitations 1
- Nocturia (nighttime urination) 1
- Hematuria (blood in urine) 1
- Peripheral edema (leg swelling) 1
- Claudication (leg pain with walking) 1
Important Clinical Distinction
The presence of symptoms does NOT correlate with blood pressure severity in most cases. 1 Patients can have severely elevated blood pressure (>180/120 mmHg) without any symptoms whatsoever. 2
Symptoms become clinically significant only when they indicate acute target organ damage (hypertensive emergency), which requires immediate intervention. 3, 4 In these cases, symptoms reflect the specific organ being damaged rather than the hypertension itself. 3, 4
Symptoms Suggesting Hypertensive Emergency (Requiring Immediate Care)
These symptoms indicate acute organ damage and require ICU admission:
- Severe headache with altered mental status, seizures, or cortical blindness (hypertensive encephalopathy) 3, 4
- Acute chest pain (acute coronary syndrome or aortic dissection) 3, 4
- Sudden severe shortness of breath (acute pulmonary edema) 3, 4
- Acute neurological deficits (stroke or intracranial hemorrhage) 3, 4
Symptoms Suggesting Secondary Hypertension
These symptoms warrant investigation for underlying causes: