High Blood Pressure: Symptoms, Warning Signs, and What to Do?

High blood pressure often goes unnoticed for a long time. Many people with high blood pressure have no clear symptoms. That is why regular checking is so important: Even if you feel fine at first, blood pressure that is too high can put strain on your blood vessels, heart, brain, kidneys, and eyes.

Still, high blood pressure can cause symptoms. Typical, non-specific complaints include headaches, dizziness, ringing in the ears, shortness of breath, or a pounding heartbeat. These symptoms alone do not prove that you have high blood pressure, but they should not be ignored if they keep coming back, persist, or occur along with elevated readings.

What symptoms can high blood pressure cause?

The following complaints can occur with high blood pressure. However, they are not proof, because they can have many other causes as well.

• Headaches, especially in the morning or in the back of the head
• Dizziness or a feeling of lightheadedness
• Ringing in the ears or tinnitus
• Sleep problems
• Nervousness or inner restlessness
• Flushed face
• Nosebleeds
• Shortness of breath or reduced exercise tolerance
• Fatigue or getting tired quickly
• Nausea
• Pounding heart or irregular heart rhythms
• Vision problems

Important: Many people with high blood pressure have no symptoms at all. On the other hand, having one of these symptoms does not automatically mean your blood pressure is too high. What matters most are repeated, correctly measured blood pressure readings.

Warning signs: When is high blood pressure an emergency?

Very high blood pressure readings can become dangerous, especially if symptoms are present. If your readings are in the range of about 180/120 mmHg or higher, you should check your blood pressure again after a few minutes of rest. If the readings stay very high or warning signs appear, medical help is needed.

These kinds of symptoms can indicate a hypertensive crisis or a hypertensive emergency. It is not only about the number on the blood pressure monitorit also matters whether there are signs of an acute strain on your brain, heart, eyes, kidneys, or blood vessels.

Morning headaches and sleep problems

Blood pressure usually drops during the night and is often lower while you sleep than during the day. If this overnight drop does not happen or your blood pressure is high at night, sleep problems or headaches in the morning can occur.

These headaches are often described as being in the back of the head and may improve throughout the day. However, they are not specific for high blood pressure. If headaches are new, severe, recurring, or occur along with elevated blood pressure readings, the cause should be checked by a doctor.

Learn more: Blood pressure over the course of the day.

Dizziness, ringing in the ears, and vision problems

Dizziness, ringing in the ears, or temporary vision problems can occur with high blood pressure readings. However, they can also have many other causesfor example, issues with the inner ear, dehydration, medications, stress, or low blood pressure.

If these symptoms occur together with clearly elevated blood pressure readings, do not dismiss them. Sudden vision problems, speech difficulties, weakness, or severe headaches are warning signs.

Flushed face and nervousness

A flushed face is often linked to high blood pressure. In reality, it often has other causes, such as warmth, alcohol, stress, excitement, or skin conditions.

Nervousness and inner restlessness can also temporarily raise blood pressure. This can easily create a cycle of stress, repeated measuring, and increasing worry. Measurement series taken while at rest under comparable conditions are more meaningful than single readings.

Nosebleeds with high blood pressure

Nosebleeds are usually harmless and often have local causes in the lining of the nose. But frequent, heavy, or difficult-to-stop nosebleeds should be checked.

If nosebleeds occur along with very high blood pressure readings, headaches, dizziness, vision problems, or shortness of breath, you should seek medical advice.

Shortness of breath and reduced exercise tolerance

Shortness of breath or reduced exercise tolerance can occur with long-standing high blood pressure, especially if the heart or blood vessels are already under strain. People may notice, for example, that climbing stairs, walking briskly, or everyday activities feel harder than before.

Shortness of breath should be taken especially seriously if it is new, gets worse, occurs at rest, or comes along with chest pain, a racing heart, dizziness, or very high blood pressure readings.

Pounding heart and irregular heart rhythms

Some people notice a pounding heart, a racing heartbeat, or irregular heartbeats when their blood pressure is elevated. These complaints can also have many causes. Repeated racing heartbeat, an irregular pulse, chest pain, or shortness of breath should be evaluated medically.

If you document your blood pressure and pulse, this information can help during your doctors appointment.

High blood pressure in women: Are there special symptoms?

The typical symptoms of high blood pressure are not fundamentally different in women and men. However, women often seek help for complaints such as headaches, dizziness, sleep problems, inner restlessness, or a pounding heart.

Women should be especially alert during pregnancy and the postpartum period: elevated blood pressure readings, severe headaches, vision problems, pain in the upper abdomen, significant swelling, or sudden feeling unwell should be checked by a doctor.

High blood pressure: What can you do?

If you notice symptoms or measure high readings, it makes sense to stay calm and proceed systematically.

1. Sit down and rest for a few minutes.
2. Measure your blood pressure again correctly while you are at rest.
3. Write down your blood pressure, pulse, time, and symptoms.
4. If the readings are repeatedly high, schedule a doctors appointment.
5. If readings are very high or warning signs appear, seek medical help right away.

A single elevated measurement does not automatically mean you have high blood pressure. But repeatedly elevated readings should be checked. Do not change or stop blood pressure medications without first talking to your doctor.

From when do you call it high blood pressure?

In many European classifications, repeated readings starting at about 140/90 mmHg are considered high blood pressure. However, for your individual treatment, target values are important. These depend on, among other things, age, pre-existing conditions, medications, and how well they are tolerated.

You can find an overview here: Blood pressure values table and normal ranges.

Why measuring is more important than symptoms

High blood pressure can exist for years without causing clear symptoms. That is why you should not wait until symptoms appear. Regular checks at home, in a doctors office, or at a pharmacy can help you spot elevated values early.

It is important to measure correctly: Sit quietly, fit the cuff properly, keep your arm at heart level, and dont talk during the measurement.

Learn more: How to measure your blood pressure correctly.

Documenting your blood pressure readings

If your blood pressure readings are repeatedly elevated, keeping a regular record can help. With BloodPressureDB, you can track your blood pressure, pulse, symptoms, and medications and review the information before your doctors appointment.

More about the BloodPressureDB app

Frequently asked questions about high blood pressure and symptoms

Can you feel high blood pressure?

Often, no. Many people with high blood pressure have no complaints. Some people report headaches, dizziness, ringing in the ears, shortness of breath, a pounding heart, or vision problems. The only way to confirm high blood pressure is by measuring it.

Are headaches a sign of high blood pressure?

Headaches can occur with elevated blood pressure, especially with very high readings. But they often have other causes. New, severe, or recurring headaches should be checked, especially if high blood pressure readings are measured at the same time.

Is a red face a symptom of high blood pressure?

A red face can have many causes and is not a reliable sign of high blood pressure. If a strongly flushed face occurs together with very high blood pressure readings, headaches, shortness of breath, nausea, dizziness, or vision problems, you should seek medical advice.

What should you do with 180 over 120?

Rest for a few minutes and measure again. If the value stays around 180/120 mmHg or higher, or if symptoms such as chest pain, shortness of breath, weakness, speech problems, vision problems, or severe headaches occur, you should seek medical help right away.

Which symptoms indicate a hypertensive emergency?

Warning signs include, among others, chest pain, shortness of breath, neurological deficits, speech problems, confusion, severe headaches, vision problems, disturbances in consciousness, or very high readings that remain even after rest.

Is one high measurement enough to diagnose high blood pressure?

Usually not. The diagnosis is typically based on repeatedly elevated readings, correctly performed home measurements, measurements in a doctors office, or a 24-hour blood pressure recording.

Sources

• German Hypertension League: Patient guide
• Internists Online: High blood pressure – warning signs and emergency
• German Heart Foundation: systolic and diastolic blood pressure
• BloodPressureDB: Blood pressure values table and normal ranges