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Hypertension symptoms
 Hypertension symptoms are uncommon in most patients with high blood pressure. Hypertension is called "the silent killer" because of the relative absence of hypertension symptoms. In most cases, the diagnosis of hypertension is accidentally made when a patient is being examined for some other condition, not because of hypertension symptoms.
Part of the problem is that hypertension symptoms are non-specific and are frequently due to causes other than an elevated blood pressure. Some of the complaints commonly considered to be hypertension symptoms include: headache, dizziness, blurred vision, blackouts, confusion and tinnitus. However, when physicians are consulted because of such problems, further investigation reveals that they are not hypertension symptoms, even when the blood pressure is high.
A not uncommon scenario is that a patient experiences headache, dizziness or other hypertension symptoms and is concerned about an impending stroke, especially if there is some relevant family history. The physician is apt to find the blood pressure high due to stress but to be on the safe side, explains the potential seriousness hypertension symptoms, prescribes an antihypertensive medication and advises dietary and other lifestyle changes.
The headache and dizziness, which may also be due to stress rather than representing hypertension symptoms may persist, causing more stress. On subsequent visits, the blood pressure is apt to be even higher, leading to an increase in dosage or adding other medications. In some instances, increased antihypertensive drugs can cause similar or other complaints that are now interpreted as a worsening of hypertension symptoms.
We know this because in instances when such patients are hospitalized for other problems, blood pressure subsequently returns to normal even though no antihypertensive drugs were given. However, following discharge, blood pressures are again high in the physician's office because of "white coat" hypertension that is transient and due to stress. This has been confirmed by ambulatory blood pressure monitoring studies showing that their blood pressures are normal most of the time, even when presumed hypertension symptoms persist. Only people with severe hypertension or a rapid rise in blood pressure are likely to experience warning headaches, blurred or impaired vision and other hypertension symptoms.
Hypertension symptoms in other instances may be due not to an elevated blood pressure per se but rather resulting complications such as heart failure or kidney damage that cause shortness of breath, ankle swelling and other complaints. While these are not generally viewed as hypertension symptoms they are indicative of an even more serious problem.
Whether or not you have hypertension symptoms, it is important to have your blood pressure checked periodically. If it is found to be consistently elevated in settings other than a physician's office it is essential to find the cause, since appropriate treatment can prevent stroke, heart attack, heart failure and other complications. The problem is that hypertension is not a discrete diagnosis, like diabetes, where, unlike hypertension symptoms, complaints point to the condition, the choice of medications is clear and their results predictable.
Hypertension is a merely a description of an elevated blood pressure, just as fever is a description of an elevated temperature rather than a diagnosis. Like fever, hypertension can have many causes requiring very different treatments. There are well over 80 drugs available to treat hypertension but it is difficult to predict which is the best for you regardless of your hypertension symptoms. Some could do more harm than good even if they lower blood pressure or alleviate presumed hypertension symptoms.
Similarly, almost all patients with hypertension symptoms and high blood pressure are advised to restrict salt and high sodium dairy products. However, this benefits only a small fraction of hypertensives and can worsen things in those who respond to calcium supplementation since dairy products are a major source of calcium.
Fortunately, renin profiling may identify those patients with or without hypertension symptoms who are salt sensitive and likely to respond to thiazide diuretics as opposed to others who require different drugs that lower renin. For more about hypertension symptoms see Topics Of Interest, John Laragh interview and other www.stress.org articles and Newsletters.
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