The Absence of High Blood Pressure Symptoms

…Prompts us to call it the Silent Killer; but some high blood pressure symptoms do occur. We have to view these statements in proper context as this discussion and practical guide shows. Normally, high blood pressure does not cause symptoms and this makes up 90% of cases. We call it the silent killer for good reason.

There are two sets of circumstances under which a person might have high blood pressure symptoms:

The first is when there occurs a disease that causes high blood pressure so that the symptoms of high blood pressure are those of the underlying disease. This is called secondary hypertension.

The second circumstance is when the effects of hypertension start to damage one or more of the usual target organs; brain, kidneys, heart, eyes or blood vessels. Then symptoms of the damaged organ manifest themselves. This is a late stage of primary hypertension, the large majority of cases (90%) described above.

Thus we can see that unless we have a disease causing our hypertension (secondary) or are in the late stage of hypertension (primary), we have no symptoms of high blood pressure!

Let’s discuss these two circumstances, late-stage primary and secondary hypertension and their symptoms.

Late-stage Primary Hypertension

Primary hypertension not only has no symptoms in the early stages but has no cause that we can determine. Yes, there are a host of symptoms that are popularly associated with high blood pressure but they occur no more frequently than in the general population. Therefore that makes this association invalid. These symptoms include headache, nosebleeds, dizziness, flushed/red face, fatigue, stress and a feeling of inner pressure. There is no correlation other than chance.

Do not assume that any symptoms are high blood pressure symptoms. Do not rely on the absence of symptoms to conclude that you don’t have elevated pressure. This could be a serious mistake.

The real symptoms of primary hypertension occur when the pressure has been high enough and present long enough to damage target organs mentioned above; brain, kidneys, eyes, heart and blood vessels. Yes, when high blood pressure symptoms occur, it is too late to avoid damage. This damage in turn causes headache, fatigue, visual impairment, nausea, vomiting, shortness of breath or urinary symptoms.

An even worse scenario occurs when severe high blood pressure causes the brain to swell with nausea, vomiting, confusion, worsening headache, drowsiness, seizures and unconsciousness. Its name is Hypertensive Encephalopathy (encephalo...means head) and requires vigorous emergency measures.

Secondary Hypertension

As mentioned above the symptoms of this category are those of the underlying causative disease. Some examples of diseases that cause hypertension and the symptoms they cause are listed here:

  • Obstructive sleep apnea:   Snoring, daytime somnolence, obesity

  • Renal parenchymal disease:   Edema, other renal symptoms

  • Renovascular disease:   Systolic/diastolic abdominal bruit (abnormal sound)

  • Excess catecholamines:   Sympathomimetics, perioperative setting, acute stress, tachycardia

  • Coarctation of aorta:   Abnormal symptoms with exertion

  • Cushing's syndrome:   Weight gain, fatigue, weakness, hirsutism, amenorrhea, moon facies, dorsal hump, purple striae, truncal obesity

  • Drug side effect:   Too numerous to list, many drugs.

  • Diet side effects:   High salt intake, excessive alcohol intake, obesity

  • Pheochromocytoma:   Paroxysmal hypertension, headaches, diaphoresis, palpitations, tachycardia

  • Hypothyroidism:   Fatigue, weight loss, hair loss, diastolic hypertension, muscle weakness

  • Hyperthyroidism:   Heat intolerance, weight loss, palpitations, systolic hypertension, exophthalmos tremor, tachycardia

  • Hyperparathyroidism:   Kidney stones, osteoporosis, depression, lethargy, muscle weakness

  • Acromegaly:   Headaches, fatigue, visual problems, enlargement of hands, feet, tongue

Doctors Practical Guide:

If you are having symptoms please do not delude yourself that you can diagnose your problem. It is very difficult. I was well into my internship before I began to have a clue what might be wrong with patients.

The bottom line here is that most people with elevated blood pressure do not have any high blood pressure symptoms. If you are having high blood pressure symptoms either you have a secondary disease which must be identified and managed or you have hypertensive damage to an organ and are having symptoms of that damage. This is a case of finding the barn door open long after the horse is gone. Don't do that with your own health, it should not and need not be that way. The best way to know what your blood pressure is for sure is to take it yourself. It's easy to learn and easy to do. See How to Take Blood Pressure


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