High blood pressure is often called the silent killer, because symptoms can be easy to ignore or miss altogether. “Hypertension is a very common condition affecting up to 40% of adults,” says nephrologist Leslie Thomas, MD. “It is one of the most common conditions for which medications are prescribed. Most people with hypertension have primary hypertension. How primary hypertension develops is not entirely understood. However, it has felt to result from many inherited and environmental factors that interact in complex ways within the body. Risks for the development of primary hypertension include family history, advancing age, obesity, high sodium diet, alcohol consumption and physical inactivity. In cases of hypertension in which a specific cause is identified, the term secondary hypertension is used. Many potential causes of secondary hypertension exist. These causes include certain prescription or over-the-counter medications, kidney disease, certain endocrine disorders, or a significant narrowing of the aorta or a kidney artery.”

So what level of blood pressure is considered too high? “Blood pressure higher than 180/120 mm Hg is considered a hypertensive emergency or crisis,” says Dr. Thomas. “Seek emergency medical help for anyone with these blood pressure numbers. Untreated, high blood pressure increases the risk of heart attack, stroke and other serious health problems. It’s important to have your blood pressure checked at least every two years starting at age 18. Some people need more-frequent checks.”

Avoid high blood pressure by eating a healthy diet, maintaining a healthy weight, not smoking, being physically active, limiting alcohol, and getting enough sleep. Here are five signs you might have high blood pressure, according to experts. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

Shortness of breath is a common sign of high blood pressure. “Pulmonary hypertension is dangerous because it disrupts the flow of blood through your heart and lungs,” says the Cleveland Clinic. “High blood pressure in your pulmonary arteries causes these arteries to become narrow. As a result, your heart must work harder to pump oxygen-poor blood to your lungs. Over time, PH damages your heart and causes problems throughout your body. It can be fatal without treatment.”

“That is the most common presenting symptom,” says Vallerie McLaughlin, MD, director of the Pulmonary Hypertension Program at the University of Michigan Frankel Cardiovascular Center. “The right side of the heart is having trouble pushing blood flow through the lungs — and it’s not getting to the left side of the heart and body. It puts strain on the right side of the heart, which is not used to pushing against the high pressure.”

“We can see changes due to vascular conditions caused by diabetes or hypertension,” says optometrist Dr. William White. “The blood vessels in the retina can become a little more stiff and hardened. They’ll push on each other and cross, like two hoses in a confined space. When it gets really bad, we’ll see some of the blood vessels start to leak, we’ll see some hemorrhaging. And that can cause a whole range of vision issues.”

“Sometimes, patients may not know they have high blood pressure — which rarely has physical symptoms, but can lead to heart disease and stroke — until they come in for an eye exam,” says Dimitra Skondra, MD, PhD. “I have had patients come in for a regular checkup, and I found some evidence of changes in the ratio or shape of retinal vessels or small blood clots in the eye. The clots were not affecting their vision, and the patients were discovered to have high blood pressure and high cholesterol.”

Headaches and high blood pressure are linked, experts say. “The vast majority of people have no symptoms whatsoever from high blood pressure,” says cardiologist Luke Laffin, MD, noting however that if blood pressure suddenly spikes to an unusually high level, a headache could happen. “If you have a sudden, intense headache that’s significantly worse than usual and your blood pressure is elevated, you should seek medical attention. Another thing to remember about headaches and blood pressure is that it’s not always the blood pressure that causes a headache. It could be the other way around. Sometimes, it’s a chicken and the egg scenario. We don’t know which comes first. Headaches can cause an elevation in blood pressure.” 

Headaches that occur in combination with other symptoms should not be ignored. It’s also useful to know if certain foods might trigger headaches. “If you notice a spike in blood pressure, that elevated number in itself doesn’t mean you need to go to a hospital,” Dr. Laffin says. “But if it’s coupled with something new, like a severe headache, severe chest pain or shortness of breath, then you should go get evaluated.”  

High blood pressure can cause sexual dysfunction, according to experts. “Over time, high blood pressure damages the lining of the blood vessels and causes arteries to harden and narrow (atherosclerosis), limiting blood flow,” says the Mayo Clinic. “This means that less blood flows to the penis. For some men, the decreased blood flow makes it difficult to achieve and maintain erections. This problem is called erectile dysfunction. It’s fairly common.”6254a4d1642c605c54bf1cab17d50f1e

“The inability to have and maintain an erection becomes increasingly common in men as they reach age 50. But men with high blood pressure are even more likely to experience erectile dysfunction. That’s because limited blood flow caused by high blood pressure can block blood from flowing to the penis. Women may also experience sexual dysfunction as a result of high blood pressure. Reduced blood flow to the vagina can lead to a decrease in sexual desire or arousal, vaginal dryness, or difficulty achieving orgasm.”

High blood pressure can lead to hypertensive heart disease over time, experts warn. “Chronic high blood pressure puts a strain on your heart and makes it harder for it to pump your blood. Your heart muscle can get thick and weak, possibly leading to heart failure,” says the Cleveland Clinic. “The walls of your blood vessels can also thicken because of high blood pressure, and this becomes more dangerous when cholesterol collects inside the blood vessels. Then your heart attack and stroke risks go up.”“In terms of your heart, there is a strong link between hypertension and coronary artery disease,” says Kavitha Kalvakuri, MD, a cardiologist at OSF HealthCare Cardiovascular Institute. “Blockages and coronary artery disease development can be accelerated by hypertension. A weak heart muscle is another consequence of uncontrolled hypertension. Think of blood pressure as the mountain and the heart as the horse. The higher one is, the harder the other has to work.”