7 Signs of High Blood Pressure and Stages of Hypertension

Heart attacks and strokes are the leading causes of death in the United States and high blood pressure is one of the main factors that contributes to these conditions. With 1 in 3 American adults suffering with hypertension (high blood pressure), it is understandable why this condition is a major public health concern. It is estimated that as many as 20% of adults with hypertension do not even know that they have an elevated blood pressure.

How To Spot Hypertension

Hypertension is often labeled as the silent killer because there are usually no signs and symptoms to indicate that the blood pressure is elevated. A person may go for months, years and sometimes even decades without being aware of the high blood pressure. Eventually the persistent elevation of pressure leads to complications. However, with a greater focus on routine screening, many people discover their hypertension well before complications arise.

Most cases of hypertension are known as primary or essential hypertension. This is where there is an elevation of the blood pressure arises gradually for no known reason. It tends to arise around the age of 45 years. Men are often more prone but by the age of 60 years both men and women are equally at risk. Secondary hypertension is less common. It is a consequence of some underlying disease and can affect any person of any age.

Read more on hypertension explained.

Warning Signs and Symptoms

Contrary to popular belief, you will not experience a headache and dizziness or even a nosebleed as is often thought to be the typical symptoms of hypertension. These symptoms may sometimes occur but usually it is only present when the hypertension is severe in what is known as a hypertensive crisis. Remember that the most reliable way to diagnose hypertension is by taking a reading with a blood pressure monitor (sphygmomanometer) and not by assessing the possible symptoms.

Furthermore these symptoms are not specific for hypertension. Most cases of headaches are due to muscle strain and spasm involving the neck and back. Dizziness can occur for a host of different reasons including low blood glucose levels, anemia, intoxication and lung disease. Similarly there are more common causes of nosebleeds other than hypertension, such as picking the nose, environmental dryness and infections.

Who is at risk?

Apart from age, there are a number of other risk factors that contribute to hypertension. This include:

  • Being overweight or obese
  • Family historyof hypertension.
  • Physically inactive lifestyle.
  • Tobacco smoking.
  • Excessive alcohol intake.
  • High dietary salt intake.
  • Low dietary potassium intake.
  • Psychological stress.
  • Chronic diseases like diabetes and kidney disease.

Stages of Hypertension

It is important to understand what a hypertensive crisis is because when people with hypertension are symptomatic, it is usually when they have reached the stage classified as hypertensive crisis.

Normal Hypertension

Normal blood pressure is said to be around 120mmHg/80mmHg but this is actually the limit of the normal level. This means a systolic pressure of 120 mmHg and a diastolic pressure of 80 mmHg. A blood pressure reading not exceeding this level is considered normal, for example a blood pressure of 115 mmHg/ 75 mmHg is normal. Very low blood pressure (hypotension) can also be dangerous.


Prehypertension is where the blood pressure is 120mmHg/80mmHg and higher but not exceeding 140mmHg / 90mmHg. In other words it is a blood pressure reading of 120 to 139 mmHg (systolic) or 80 to 89 mmHg (diastolic). This stage means that a person is at risk of developing hypertension. Dietary and lifestyle changes should be implemented to lower the pressure so as to prevent hypertension stage 1.

Hypertension Stage 1 and Stage 2

Hypertension (high blood pressure) is a blood pressure exceeding 140 mmHg (systolic) or 90 mmHg (diastolic). It can be further subdivided into stage 1 and stage 2. In stage 1 hypertension the reading is from 140 to 159 mmHg (systolic) or 90 to 99 mmHg (diastolic).  In stage 2 hypertension the reading is from 160 (systolic) or 100 mmHg (diastolic). There may still be no symptoms in both stage 1 and stage 2 hypertension.

Hypertensive Crisis

Hypertensive crisis is a very dangerous stage of high blood pressure. It is where the blood pressure exceeds 180 mmHg / 110 mmHg. This means that the systolic pressure is higher than 180 mmHg or the diastolic pressure is higher than 110 mmHg. It is at this point that symptoms may be present. A hypertensive crisis is very serious and requires immediate medical attention, even if blood pressure medication is being used.

Read more on hypertension medication.

Severe Headache

A severe headache is often thought to be a sign of hypertension. Studies have shown that this is not true and people with hypertension had fewer headaches than people with normal blood pressure who were part of this study group. However, a severe headache is a common complaint when a hypertensive crisis arises. It is often accompanied by confusion and blurred vision.

Shortness of Breath

Shortness of breath is another symptom that is reported with hypertension. It is occurs with thickening and stiffening of the heart wall as a result of the continuous elevation of the blood pressure. Similar to other symptoms, shortness of breath is more pronounced with hypertensive crisis. Other causes also need to be considered like angina or a heart attack which is more likely to occur with hypertension.

Chest Pain and Palpitations

Hypertension affects the heart in various ways. A person may experience a pounding in the chest as the heart beats harder. This is known as palpitations. The heartbeat may also become irregular. Severe chest pain can also occur especially in a hypertensive crisis. As with other symptoms like shortness of breath, severe chest pain must be investigated further as it could be a sign of a heart attack.


The elevation in blood pressure can cause tiny blood vessels to burst since these vessels cannot handle the force within it. These tears or ruptures in the tiny vessels are usually not seen and may quickly become sealed off with clots. However, it can lead to bleeding like nosebleeds. Once again this is more likely in a hypertensive crisis and is rarely seen with stage 1 or stage 2 hypertension.

Seizures and Loss of Consciousness

High blood pressure affects the brain in several ways. With the brain tissue being so sensitive to changes, particularly changes in the blood oxygen levels, a person may experience seizures. Sometimes there may even be loss of consciousness although this is uncommon. Both instances are more likely to occur with a hypertensive crisis. The impact on the central nervous system may also result in anxiety or even nausea.


  1. www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/hypertensive-crisis
  2. www.heart.org/HEARTORG/Conditions/HighBloodPressure/SymptomsDiagnosisMonitoringofHighBloodPressure/What-are-the-Symptoms-of-High-Blood-Pressure
