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Symptoms, signs and risks of high blood pressure

High blood pressure, or hypertension, doesn’t usually cause any obvious symptoms.

The British Heart Foundation estimates that as many as 7 million people in the UK have undiagnosed high blood pressure.

Left untreated, hypertension can lead to serious diseases, including stroke, heart disease, kidney failure and eye problems. High blood pressure is sometimes called 'the silent killer'.

The only way to find out if you have high blood pressure is to get your blood pressure measured. All adults should have their blood pressure checked at least every 5 years.

Regular checks are especially important if you have a close relative who has high blood pressure.

Symptoms of very high blood pressure

If your blood pressure is extremely high, there may be certain symptoms to look out for including:

If you have any of these symptoms, seek medical advice immediately. You could be having a hypertensive crisis that could lead to a heart attack or stroke.

Hypertension risk factors

Although the exact cause of hypertension (high blood pressure) is unknown, there are several factors and conditions that may increase risk. These are:

  • Overweight and obesity
  • Smoking
  • Little or no exercise
  • Too much salt in the diet
  • Drinking too much alcohol
  • Stress
  • Ethnic background - being a black person of African or Caribbean descent or of South Asian descent
  • History of high blood pressure in the family

Malignant (accelerated) hypertension

Organ damage can be a result of severely elevated high blood pressure that occurs with malignant (accelerated) hypertension. When this happens blood pressure must be reduced immediately to prevent organ damage. This is done in an intensive care unit of a hospital.

Organ damage associated with malignant (accelerated) hypertension may include:

  • Changes in mental status such as confusion or coma (encephalopathy)
  • Bleeding into the brain (stroke)
  • Heart failure
  • Chest pain (angina)
  • Fluid in the lungs ( pulmonary oedema)
  • Heart attack
  • Aneurysm (bulging blood vessel)
  • Eclampsia (occurs during pregnancy)

Fortunately malignant hypertension is rare. When it does occur it is often when hypertension goes untreated or if the patient does not take his or her medication.

Symptoms of malignant hypertension

The symptoms of a hypertensive emergency include:

  • Headache
  • Seizure
  • Chest pain
  • Shortness of breath
  • Swelling or oedema (fluid build-up in the tissues)

Diagnosing malignant hypertension

To diagnose malignant hypertension the doctor treating you will ask you several questions to get a better understanding of your medical history. He or she will also need to know all the medicines you take including non-prescription and recreational drugs. It is also important to tell your doctor if you are taking any herbal or dietary supplements.

Certain tests will be performed to monitor blood pressure and assess organ damage including:

  • Regular monitoring of blood pressure
  • Eye test to look for swelling and bleeding
  • Blood and urine testing

What's the treatment for malignant hypertension and associated organ damage?

In malignant hypertension the first goal is to bring down the blood pressure as quickly as possible with intravenous (IV) blood pressure medications, to prevent further organ damage. Whatever organ damage has occurred is treated with therapies specific to the organ that is damaged.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on October 12, 2017

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