Hypertension is a silent killer, which means that patients do not necessarily need to experience signs and symptoms, and the medical condition is still active and creating mounting problems. High blood pressure is a chronic cardiovascular problem that is often associated with other diseases such as diabetes, myocardial infarction and atherosclerosis. It becomes more common as we age, and should be differentiated from the normal rise in blood pressure experienced during exercise or when experiencing emotional distress.
But even though hypertension tends to be asymptomatic, there are key signs and symptoms that patients commonly experience in a hypertensive crisis, an emergency situation where blood pressure levels rise to alarmingly high levels. The signs and symptoms of a hypertensive crisis are as follows:
The blood vessels in the brain are susceptible to blood pressure, and one of the most widely known symptoms in a hypertensive crisis is a headache. However, it might not be as common as people think because according to studies, only a minor percentage of the population with hypertension suffers from headaches. It is typically a pounding headache that is felt in the neck area predominantly but may have different features according to each case. In these patients, it is important to differentiate tension headaches from migraines and other causes of headache, which may coexist in a patient with known hypertension.
Besides the blood vessels in the brain, another group of susceptible arteries are those found in the nasal mucosa. In the event of high blood pressure, sometimes these tiny blood vessels are ruptured and start leaking out blood. Nosebleeds are more common in some patients but may never arise in others. Other causes of nose bleeding include low protein levels in the blood, sudden changes in altitude, temperature changes, prolonged sunlight exposure, and much more. Thus, by itself, nosebleed is not a leading sign to suspect hypertension.
3. Facial flushing
During a hypertensive crisis, patients may display visible symptoms, such as facial flushing. It is a change in the colouration of the skin that results from the dilation of the superficial articles of the skin. Facial flushing is also common in other stressful events, especially in white people.
Patients with a heart condition usually have palpitations, especially when their blood pressure is high. In a hypertensive crisis, the heart pumps blood with an increased load, and if the patient has a heart condition, it is more likely to feel your heart racing or pounding. Patients with a heart rhythm problem should be extra careful because they are more likely to undergo cardiovascular complications.
5. Chest pain
Chest pain and high blood pressure is a dangerous combination. Myocardial infarction is a predominant cause of death in western countries, and it is often diagnosed in patients with chest pain and high blood pressure. Still, there are many causes of chest pain, and not all of them are dangerous or life-threatening. Thus, go to your doctor and ask about your symptoms if you’re in doubt.
6. Visual problems
During a hypertensive crisis, it is common to experience blurry vision and other visual problems. Moreover, hypertensive retinopathy is a common consequence of hypertension when the issue goes on for many years without a diagnosis or treatment. Visual problems can be transient in hypertensive crisis or sustained in hypertensive retinopathy, and range from mild to severe according to each case.
Most patients with a hypertensive crisis come to the emergency room agitated and anxious, and this can be a cause or a consequence of hypertension, sometimes both. Anxiety, stress, and other negative emotional states are known to trigger hypertension, even in patients with no known cardiovascular problems. In patients with hypertension is often the trigger of a hypertensive crisis. At the same time, when patients feel alarming symptoms such as a severe headache, palpitations and chest pain, they become agitated and scared and may even worsen their own condition. Therefore, if you’re facing these symptoms, it is important to remain as calm as possible and go to the emergency room.
In some cases, especially in the elderly and some susceptible populations, hypertensive crises might also come with an alteration in the level of consciousness. These patients can no longer hold a conversation, tend to forget things or become unresponsive. In any case, it is important to pay attention to these cases right away because it is likely caused by hypertension, another vascular disease, a metabolic alteration or any other severe problem that needs urgent attention.
Even if patients do not experience confusion or any major neurologic event, they may feel lightheaded and dizzy during a hypertensive crisis. It is common to feel muscle weakness, a difficulty to walk or stand, In any case, it is important to pay attention to these symptoms, especially when accompanied by others in this list because, even though it is a common complaint in many ailments, it is not considered normal, and chances are it is associated with cardiovascular disease.
In some cases, a hypertensive crisis might end up triggering a seizure. This is not common in every single patient but a subgroup of patients with a susceptibility to this type of events. It is important to note that pregnant women with hypertension might develop a condition called eclampsia, which is a severe complication in pregnancy that may lead to miscarriages and preterm labour. These cases require urgent hospitalisation when high blood pressure levels are detected.
The signs and symptoms we have covered about hypertension are not necessarily found in every patient. We should stress that hypertension is an asymptomatic ailment by itself and these symptoms are likely found in a hypertensive crisis, an acute event in which blood pressure readings go higher than the baseline and reach alarming levels. Thus, even if you feel everything is normal and you don’t have any of the signs and symptoms in this article, it is essential to talk to your doctor and get your annual screening tests done to prevent cardiovascular disease and maintain a healthy body and mind.