Symptoms of Hypertension
Hypertension (HBP) is a cardiovascular disease defined by high blood pressure (usually related to abnormal functioning of the vascular system). Often multifactorial, hypertension can be acute or chronic, with or without signs of gravity. High blood pressure is defined by a systolic blood pressure greater than 140 mmHg and diastolic blood pressure greater than 90 mmHg.
Most people are unaware of their high blood pressure because in the early stages there are no symptoms.
Hypertension is a real public health problem. More than a quarter of the world’s adult population (26.4%) suffers from it. In addition, it is responsible for 7 million deaths a year worldwide, and the number of hypertensive adults is expected to grow by 60% to reach 1.56 billion in 2025.
Usual symptoms of hypertension:
Hypertension evolves most often insidiously and more than half of hypertensive patients are not aware of their pathology. The occurrence of symptoms often reflects an advanced stage of the disease.
Given the danger related to high blood pressure, doctors often call it “the silent killer”. The only way to diagnose it early is to measure the blood pressure.
Its symptoms are essentially nonspecific and often correspond to the suffering of certain organs (like the brain, the heart and kidneys). The most frequent are:
- Headaches: They are mainly characteristic of severe hypertension. Hypertension headaches are classically chronic, present in the morning, in the occipital region (neck and above) and sometimes take a pseudo-migraine appearance. Hypertensive peaks can also cause acute headaches.
- Tinnitus (auditory whistling): This symptom is related to the fact that the microcirculation in the inner ear can be damaged by hypertension. In addition, the blood vessels, under significant pressure, generate a noise that is perceived by ear (pulsatile tinnitus).
- Phosphenes (perception of bright spots): This symptom is related to the fact that hypertension stimulates the ganglion cells of the retina and excite them abnormally.
- Vertigo: This symptom is most often due to dysfunction of the inner ear (the vestibular system). The headache and tinnitus can also aggravate vertigo.
- Palpitations (pounding in chest): They are most often related to a fast heart rate in hypertensive patients.
- Asthenia (weakness): It is most often associated with heart fatigue and cerebral microcirculatory disorders caused by hypertension. This symptom often reflects a vascularization trouble of different organs.
- Dyspnea while doing physical efforts (difficulty breathing): Dyspnea, like asthenia, is often due to associated heart fatigue. In more severe cases, it is caused by very advanced heart failure and may be evidence of acute pulmonary edema.
- Epistaxis (nosebleeds): Following the increase of the blood pressure. Some fragile vessels, such as those located on the inner side of the nasal cavity may rupture and bleed.
- Hematuria (presence of blood in the urine): High blood pressure can severely damage renal function. Thus, it can cause a passage of red blood cells in the urine.Serious clinical manifestations of hypertension:How does hypertension affect organs?
Very often, the symptoms mentioned above are absent and may go unnoticed. In these cases, hypertension develops insidiously, damages the cardiovascular system of the patient and is manifested only later by severe clinical presentations that will make the patient go to the emergency room (ER).
This evolution of the disease can be:
- The “mechanical” consequence of the increased arterial pressure on the vessels (rupture of the latter with hemorrhages);
- The “mechanical” consequence on the heart pump working at high pressures for a long time and getting tired in the long run;
- The consequence of the favoring of the formation of the atheroma plaques, which progressively obstructs the arteries.
The main organs damaged by hypertension are the heart, brain and kidneys.
Neurological symptoms of hypertension :
Central nervous system involvement is common. It manifests itself by the possible occurrence of:
- Hemorrhagic stroke due to the rupture of a cerebral vessel, or ischemic stroke due to the obstruction of an artery by atheroma or by a thrombus. According to the WHO, a hypertensive patient is 2 to 3 times more likely to have a stroke. Strokes’ symptoms are various: hemiplegia, language disorders, sensory disorders, cognitive disorders, even coma or sudden death.
- Hypertensive encephalopathy (the more common symptoms are disturbances of consciousness, retinopathy with papillary edema, seizures…).
- Arterial dementia, by diffuse and chronic damage of the cerebral arteries by hypertension.Renal symptoms of hypertension :
Hypertension is responsible for an important damage to the glomeruli (functional units of the kidney) and promotes the occurrence of renal failure. Impaired renal function is often very moderate in the beginning, but may progressively worsen. According to the WHO, this risk of renal failure is multiplied between 2 to 10 times in the hypertensive patients.
In final kidney failure stage, the hypertensive patient may present with acute edema of the lungs, intense asthenia or even cardiac rhythm disorders or sudden death (especially related to the absence of renal elimination of potassium).
Cardiac symptoms of hypertension :
The increased workload of the heart due to increased blood pressure results in a very early deterioration of cardiac function, causing signs of heart failure. This phenomenon is more aggravated by atherosclerosis that affects the coronary arteries (which vascularize the heart).
In the long term, a hypertensive patient will present himself to the emergencies with these signs:
- Acute edema of the lung. (Dyspnea at rest, signs of asphyxia).
- Edema of the lower limbs.
- Abdominal swelling, etc.Other serious symptoms related to hypertension :
- In pregnant women, hypertension can cause in-utero fetal death. High blood pressure causes circulation challenges between the mother and fetus which has the potential to be deadly for both. The condition is know as preeclampsia
- Various vascular complications: Like Aortic dissection (urgent and severe manifestation causing intense chest pain and requiring urgent treatment) and Peripheral arterial disease (gait disturbances due to vascularization abnormalities of the lower limbs).
It should be noted that in 90% of cases, hypertension is said to be essential: no known cause can be found in this case. In the rest of the cases, high blood pressure is secondary: several pathologies can cause hypertension. The patient can therefore come to the emergency room (ER) with signs suggestive of his pathology (such as Cushing’s disease, pheochromocytoma, etc.).
Conclusion:
To conclude, high blood pressure is an unfortunately common and serious disease that evolves insidiously. Several symptoms allow suspecting it before it causes serious manifestations that can affect the functional and vital prognosis of patients.