Singer Irene Cara passed away in Largo, Florida on November 25, 2022, at just 63 years old—and now her official cause of death has been released. According to a report from the Pinellas County medical examiner, Cara’s cause of death was arteriosclerotic and hypertensive cardiovascular disease, or a hardening of the arteries resulting from high blood pressure. Diabetes was also noted as a contributing factor. Cara’s death was confirmed at the time via a statement from her publicist Judith A Moose. “It is with profound sadness that on behalf of her family I announce the passing of Irene Cara,” the statement read. “Irene’s family has requested privacy as they process their grief. She was a beautifully gifted soul whose legacy will live forever through her music and films. Funeral services are pending and a memorial for her fans will be planned at a future date.”

According to the CDC, 47% of US adults in the United States have hypertension, which is blood pressure greater than 130 mmHg,  or a diastolic blood pressure greater than 80 mmHg. “According to the Framingham Study, hypertension accounts for about one quarter of heart failure cases,” says Kamran Riaz, MD. “In the elderly population, as many as 68% of heart failure cases are attributed to hypertension.”

Hypertension is linked to several concerning health conditions, but doctors say early detection is key to effective treatment. “When doctors deliver the diagnosis of hypertension, they package it with serious complications,” says Naomi D. L. Fisher, MD. “These include heart attack, kidney failure, and stroke. Doctors discuss risks to motivate their patients, but sometimes end up creating fear instead. And fear can lead to denial. Is hypertension serious? Yes, if left untreated. But when blood pressure is controlled, the risks are greatly reduced. The important message is that treating hypertension can prevent severe complications and add dramatically to life expectancy.” Here are symptoms of hypertension, according to experts. 

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High blood pressure can cause blood vessel damage resulting in blurred vision or loss of sight. “We can see changes due to vascular conditions caused by diabetes or hypertension,” says Dr. William White, an optometrist with Baylor Scott & White Health in Temple, Texas. “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 people will say, ‘I’m just here to get my glasses. Why are you checking my blood pressure?’ We try to inform them about the unique opportunity we have to look at these blood vessels in the eye.”

Regular checkups are crucial for catching any potential issues early. “You’re not just a pair of eyeballs walking into an exam room,” Dr. White says. “We have to look at the entire person and the whole picture. These are things that can impact their lives significantly, and we have a responsibility for their overall health. Some people don’t go for a routine checkup every year. They tell me, ‘Look, I just don’t like going to the doctor.’ But their eyes are a problem, so they’ll come to us. It’s so important because of the silent nature of this problem. People can feel absolutely fine, but high blood pressure has a cumulative effect. If it’s uncontrolled over years, it’s going to cause damage later in life.”

Dizziness, faint headedness, and confusion could be signs of hypertension. “People who have problems such as hypertension or hypotension may experience dizziness from the blood pressure itself,” says Dr. Kimberley Bell, DPT. “We may also find that there is a link between blood pressure and vertigo or dizziness, related to the vestibular system. The blood pressure and vertigo link can occur when blood pressure that is too high or too low affects the blood flow in the inner ear vestibular system.”

Reduced blood flow to the brain can also cause dizziness. “Orthostatic hypotension (OH), or postural hypotension, is more common in older adults and is associated with an increase in the rate of falls,” says Dr. Bell. “OH can cause feelings of lightheadedness when moving into any position with the head more upright. This feeling of dizziness, along with other potential symptoms of weakness, impaired cognition, and even loss of consciousness (syncopal episodes) in extreme cases, is caused by reduced blood flow to the brain. This reduced blood flow to the brain is called cerebral hypo-perfusion. It can be a link between blood pressure and vertigo, or dizzy spells with standing.”

Heart palpitations could be a sign of dangerously high blood pressure. “If the heart cannot pump blood effectively, heart failure can occur,” says Andrea Tordini, MD. “Heart palpitations on their own are not a sign of heart failure – instead, they are just one of many symptoms that can occur. Some patients experiencing heart failure may not even experience palpitations at all.”

While heart palpitations could happen for other reasons, they should not be ignored. “Believing that something could be wrong with your heart is a scary feeling,” says Dr Tordini. “Heart palpitations  can make you fear the worst, but palpitations are actually quite common and usually nothing to worry about. However, that’s not to say that you should ignore them completely. Rarely, they could be a sign of a more serious condition like atrial fibrillation or AFib. Knowing when to worry about heart palpitations can help you catch certain conditions early so that you can seek the appropriate treatment option.”

Nausea and vomiting could be a sign of a sudden hypertensive crisis. “A hypertensive crisis is a sudden, severe increase in blood pressure,” says Francisco Lopez-Jimenez, MD. “The blood pressure reading is 180/120 millimeters of mercury (mm Hg) or greater. A hypertensive crisis is a medical emergency. It can lead to a heart attack, stroke or other life-threatening health problems. Severely high blood pressure can damage blood vessels and body organs, including the heart, brain, kidneys and eyes. During a hypertensive crisis, the heart may not be able to pump blood effectively.”

Shortness of breath, headache, chest pain, and confusion are also signs of a hypertensive crisis. “If you get a very high blood pressure reading at home and don’t have any symptoms, relax for a few minutes,” says Dr. Lopez-Jimenez. “Then check your blood pressure again. If it’s still very high, seek medical care. Call 911 or emergency medical services if your blood pressure is 180/120 mm Hg or greater and you have chest pain, shortness of breath, or symptoms of stroke. Stroke symptoms include numbness or tingling, trouble speaking, or changes in vision. Treatment for a hypertensive crisis may include a hospital stay to monitor for organ damage. Medications to lower blood pressure are given by mouth or IV.”

Regular blood pressure checks are the best way to keep track of potentially dangerous hypertension. “Measuring your blood pressure at home is a straightforward process,” says nephrologist Leslie Thomas, MD. “Many people have a slightly higher blood pressure in one arm versus the other. So it’s important to measure the blood pressures in the arm with the higher readings. It’s best to avoid caffeine, exercise and, if you smoke, smoking for at least 30 minutes. To prepare for the measurement, you should be relaxed with your feet on the floor and legs uncrossed, and your back supported for at least five minutes. Your arms should be supported on a flat surface. After resting for five minutes, at least two readings are taken one minute apart in the morning prior to medications and in the evening before the evening meal. Your blood pressure monitor should be checked for proper calibration every year.”

What if blood pressure readings are erratic? “This pattern of abrupt changes in blood pressure from normal to quite high is sometimes referred to as labile blood pressure,” says Dr. Thomas. “For those who develop labile blood pressure, heart problems, hormonal problems, neurological problems, or even psychological conditions might be present. Finding and treating the underlying cause of labile blood pressure can significantly improve the condition.”