What are the symptoms of high blood pressure?

High blood pressure usually causes no symptoms, so a cuff is the only way to know. Chest pain, shortness of breath, back pain, weakness, numbness, vision change or trouble speaking need emergency services right away, whatever the number.

Why you can’t feel it

The American Heart Association calls high blood pressure the silent killer because it usually gives no signs. Many people have it for years without knowing. Feeling fine doesn’t tell you anything about your number, and the Association lists “I feel fine” as one of the common myths.

That’s the main danger, because the risk goes up with your number whether you feel it or not. Researchers pooled data on about one million adults aged 40 to 69. For every 20 points (mmHg) higher systolic (the top number), or 10 higher diastolic (the bottom number), the rate of death from heart disease and stroke was about double.

Symptoms that need emergency care

Call emergency services for any of these, whatever the number:

• Chest pain
• Shortness of breath
• Back pain
• Weakness or numbness
• Vision change
• Trouble speaking

Don’t wait to see if the symptom passes, and don’t stop to measure first. If you’ve already measured, tell the emergency team the number.

Symptoms with many causes

Headache, tiredness and feeling on edge have many causes. If one of them worries you, check your blood pressure. Sit down, rest without talking and measure at home. Then use the emergency steps if systolic is 180 or higher, or diastolic is 120 or higher.

If a headache is sudden and severe, comes with confusion or vision change, or comes during pregnancy, get care right away.

How to find out

• Measure. Take a seven-day home week with an upper-arm cuff from a validated list.
• Use the average. Enter the week in the home average tool and see where it lands on the chart.
• Keep the clinic and home numbers apart. Some people measure normal in the clinic and high at home, which is called masked hypertension.

What about a smartwatch?

If your watch hasn’t warned you, that doesn’t tell you much. Apple says not everyone with hypertension will get its notification. See can a smartwatch measure blood pressure.