Although it can be detrimental to your overall health, hypertension can be hard to recognize if you’re not regularly checking your blood pressure. In fact, Dr. Pamela Tambini, a double board-certified physician in Internal Medicine and Addiction Medicine and the Medical Director at Engage Wellness, notes that it’s often called the “silent killer” because it typically has no symptoms until it reaches dangerous levels. However, there are a few warning signs of high blood pressure that signal the body is under extreme stress in some cases. Keeping an eye out for these symptoms so you spot hypertension early is a crucial part of lowering your risk of complications like heart attack, stroke, and kidney damage.
But what are those warnings signs, and which are the most concerning? We spoke to Dr. Tambini to find out. She highlighted several concerning red flags, including severe headaches, mood swings, and more. Find all of her expert insight below.


1. Severe Headaches
Got a headache that doesn't seem to go away? It may be time to get your blood pressure checked. According to Dr. Tambini, frequent, intense headaches could be a sign of hypertension. "Severe headaches are one of the most common warning signs, as increased blood vessel pressure can affect brain circulation," she says. If your headaches are chronic and accompanied by dizziness or changes in vision, you should visit your doctor. Even if the pain is not due to high blood pressure, getting to the bottom of things is crucial to your health.

2. Dizziness and Blurred Vision
If you're feeling dizzy or seeing double, you may be experiencing hypertension. That's because high blood pressure affects blood flow to the brain and eyes, potentially resulting in dizziness and blurred vision. "The eyes and brain are sensitive to changes in blood flow," Dr. Tambini explains. You shouldn't ignore these warning signs that blood pressure may be spiking, calling for immediate attention.

3. Chest Pain and Shortness of Breath
Chest pains and shortness of breath are among the most common—and concerning—signs of hypertension. "Chest pain and shortness of breath are particularly concerning, as they could indicate that high blood pressure is putting excessive strain on the heart," says Dr. Tambini. Essentially, these symptoms may be a sign that your heart is struggling to pump blood effectively, which increases your risk of events like a heart attack or heart failure. Discomfort in your chest should always be taken seriously; see a doctor if you're concerned.

4. Mood Swings and Difficulty Concentrating
Physical symptoms aren't the only warning signs of high blood pressure; hypertension may even affect your emotional wellbeing. "Some people experience mood swings, anxiety, or difficulty concentrating, which may be linked to reduced blood flow to the brain or fluctuations in stress hormones triggered by hypertension," says Dr. Tambini. So, if you're irritable for no reason or can't seem to think clearly, it's not a bad idea to check your blood pressure.

5. Unexplained Nosebleeds
There are many reasons you may get a nosebleed. While Dr. Tambini notes that this isn't always a sign of blood pressure, it could be a symptom that occurs when levels are dangerously high. "Other possible symptoms include unexplained nosebleeds, nausea, or fatigue, but these are not always directly tied to high blood pressure unless it is at an extreme level," she says. If you're experiencing frequent nosebleeds alongside these other symptoms, don't hesitate to see a doctor.

6. Fatigue and Nausea
Like many of the other symptoms on this list, fatigue and nausea can be linked to a number of health issues, but they may be a concerning indication of high blood pressure, especially combined with other warning signs. This is because hypertension can reduce your body's ability to deliver oxygen and nutrients to vital organs.

7. Signs of a Hypertensive Crisis (Difficulty Speaking, Weakness, More)
When blood pressure spikes to dangerous levels—180/120 mmHg or higher—it can be life-threatening. This is known as a hypertensive crisis, and comes with a number of alarming warning signs. "If someone experiences symptoms like confusion, chest pain, difficulty speaking, or weakness on one side of the body, they should seek emergency medical care immediately," urges Dr. Tambini. If any of these symptoms occur alongside one another, it should absolutely not be ignored, lest it results in stroke, heart attack, or organ damage.

What to Do If You Experience These Symptoms
"If you have symptoms of high blood pressure, especially sudden or severe ones, do not ignore them—seek medical attention as soon as possible," Dr. Tambini warns.
It's also important not to wait for symptoms to occur, because, as we noted, hypertension often comes without signs. Dr. Tambini recommends routine blood pressure monitoring, lifestyle changes such as a heart-healthy diet, regular exercise, stress management, and avoiding smoking and excessive alcohol. "If medication is prescribed, it is crucial to take it consistently and follow up with a doctor for routine monitoring," she concludes.
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