High blood pressure impacts an estimated 116 million people in the U.S., and only about 25% of them have the condition under control. People concerned about their risk for high blood pressure often wonder what warning signs to look for. Most people don’t experience any symptoms of hypertension until the condition becomes severe. However, there are some signs of high blood pressure that you should notify your primary care provider about as soon as possible.

Symptoms of high blood pressure

Medical professionals sometimes call hypertension the “silent killer” because a person can have elevated blood pressure for years before experiencing complications. Hence, it is important that you see your doctor regularly for wellness checkups at least once a year even if you’re not experiencing any of the following symptoms. Most often by the time people begin experiencing symptoms, they are in a hypertensive crisis or are experiencing health complications like a stroke, heart attack or kidney failure.


Many people believe that chronic headaches are a common symptom of hypertension, but this is not true. High blood pressure is unlikely to trigger headaches unless you are in a state of hypertensive crisis with blood pressure readings of 180/120 mm Hg or higher. Normally, headaches caused by a hypertensive crisis are very severe.

Individuals who suffer from chronic headaches may experience elevated blood pressure levels by seeking relief through over-the-counter medications. Although it is normal for one’s blood pressure to increase from pain, Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can raise blood pressure. Those who take NSAIDs regularly for headaches may have high blood pressure readings due to the medication rather than directly from their head pain.

Nose bleeds (Epistaxis) 

Initial findings in a study conducted in South Korea found that people with high blood pressure were 47% more likely to experience nose bleeds (epistaxis) and had more severe bleeding due to them. However, more research is necessary to verify these findings and study their association.

Hypertension is not a leading cause of epistaxis. In fact, colds, allergies and sinusitis are much more common causes of epistaxis.


Sudden dizziness that doesn’t quickly subside is one of the warning signs of a stroke.  Individuals with Stage 1 or Stage 2 hypertension are unlikely to experience dizziness as a symptom. However, those with high blood pressure are at an increased risk for stroke. Of note, dizziness may be a side effect of some prescription medications used to treat high blood pressure. If you experience dizziness after starting a new blood pressure medication, you may wish to talk to your doctor about your medication regimen.

Pounding in your chest, neck, or ears

Physical strain during exercise and intense stress may temporarily cause you to notice a pounding in your chest, neck, or ears. Normally, this symptom subsides after your heart rate slows following a workout or once you calm down after a stressful event. However, if you experience persistent  pounding in the chest, neck or ears that is unrelated to stress and exercise, check your blood pressure. This can be symptoms of a hypertensive crisis.

Neck pain 

Neck pain is unlikely to be a direct result of high blood pressure, but intense pain anywhere in the body can temporarily elevate blood pressure levels. In some people, heart attacks cause pain that radiates throughout the upper body, including the neck. Because individuals with hypertension are at an increased risk for heart attack, sudden, lingering neck pain could be a sign of a medical emergency.

Ringing in ears

Some older medical studies observed that people with tinnitus or ringing in the ears also frequently had high blood pressure. Although there may be an association between the two, there is not enough evidence to prove that high blood pressure causes ringing in the ears. Tinnitus is a side effect of some diuretic medications and NSAIDs.

Chest pain

Chest pain or chest pressure can be a sign of a heart attack. Often these may also radiate to the neck or left shoulder. Hypertension puts you at an increased risk for these medical problems, but it usually does not directly cause pain or tightness in the chest. If you experience chest pain, seek emergency medical attention.

Vision Changes

Chronic, uncontrolled hypertension can eventually lead to myriad eye related complications.

A subconjunctival hemorrhage, which can occur as a result of increased blood pressure. These often present as small red spots at the white portion of the eye. Subconjunctival hemorrhages are often benign. These, in fact, are more likely to be caused by sneezing, coughing, vomiting, rubbing your eyes, contact lenses or infections. 

However, those with uncontrolled blood pressure often develop  microvascular changes in the retina, also known as hypertensive retinopathy. These tiny blood vessels grow stiff, leading to small hemorrhages within the eye, which are often described as cotton wool spots or flame hemorrhages.  

Frequently asked questions

Is there a link between high blood pressure and kidney symptoms?

Chronic high blood pressure can cause blood vessels to grow narrow, and this can eventually lead to permanent damage. When this occurs in the kidneys, it can interfere with organ function.

Some symptoms of kidney damage related to high blood pressure include:

  • Changes in the amount of urination
  • Chest pain
  • Difficulty concentrating
  • Dry skin
  • Headaches
  • Itchy skin
  • Loss of appetite
  • Nausea and vomiting
  • Shortness of breath
  • Weight loss

Can high blood pressure make you tired?

Hypertension on its own doesn’t normally cause fatigue. However, people who have hypertension and a related medical condition like coronary heart disease, PAD, or kidney disease may grow tired easily or become easily exhausted by exercise.

Can high blood pressure cause heart palpitations?

Normally, high blood pressure isn’t a direct cause of heart palpitations. People who have arrhythmia or an irregular heartbeat may experience hypertension and heart palpitations. Other conditions like electrolyte imbalances may also cause both. Substances like nicotine and caffeine also have the potential to trigger heart palpitations and blood pressure spikes.

Severe hypertension symptoms in men vs. women

Both men and women are unlikely to develop symptoms of hypertension until the problem causes damage to other parts of the body, a hypertensive crisis occurs, or they experience a heart attack or stroke.

Serious symptoms associated with high blood pressure in men and women

Alongside other symptoms, high blood pressure can be a symptom of a heart attack. Men and women’s symptoms of heart attack can be different. Men are more likely to experience typical symptoms:

  • Pressure and tightness in the chest and arms
  • Shortness of breath
  • Lightheadedness or dizziness
  • Cold sweat

In women, symptoms of a heart attack can be subtle. These symptoms are often referred to as “atypical chest pain” and include:

  • Shortness of breath
  • Nausea and vomiting
  • Back and jaw pain

Both men and women can experience typical and atypical symptoms of chest pain. Women may also experience different symptoms of high blood pressure during pregnancy.

When should you go to the emergency room for high blood pressure?

If your blood pressure is 180/120 mm/Hg or higher and you have one or more of the following symptoms, you should go to the emergency room:

  • Difficulty speaking
  • Numbness
  • Severe headache
  • Shortness of breath
  • Vision disturbances
  • Weakness

How Forward can help if you’re experiencing symptoms

If you’re experiencing symptoms of high blood pressure, Forward can perform diagnostic tests and analyses to determine if you have hypertension and other risk factors for cardiovascular disease. Our 12-week, doctor-led Heart Health Program includes diet and exercise optimization to make adopting healthy lifestyle changes easier plus ongoing support and biometric monitoring. We act as your primary care provider to help you set and achieve your health and wellness goals.

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