Unfortunately there are no early symptoms of high blood pressure. This is a disease where only prevention can help to avert a disaster such as a stroke, permanent kidney damage, irreversible heart disease or blindness. When symptoms finally occur after years of uncontrolled hypertension, the damage in the target organs is already done. The damage of uncontrolled hypertension is done on the small arteries.
The person affected with high blood pressure may experience headaches when in the past there was no history of headaches; this can come from swelling of the envelope around the brain, called meninges that contain a lot of nerve fibers. This is an alarm sign to seek medical advice, have the blood pressure measured and when high get immediate treatment for it. Not every person with high blood pressure develops headaches.
This can only be made visible by looking into the eyes with an ophthalmoscope (examination by a physician, hypertensive retinopathy detected). The damage to the small arteries leads to accelerated arteriosclerotic changes of all of the arteries including the aorta. Because of the high blood pressure and the brittleness of the aorta, a hole in the aorta can develop (aortic dissection) or a pouching out of the wall (aortic aneurysm) with leakage. These are potentially life-threatening situations with a high mortality. The heart, as a result of having to constantly pump against the high blood pressure in the arterial system, develops a thickening of the heart muscle (myocardial hypertrophy), which is visible on ECG and echocardiogram studies.
The person may be urinating often and when the doctor runs tests, there may be blood in the urine. Again, this is a late sign of hypertension and is a sign of kidney damage, which may not be reversible (hypertensive nephropathy). The key to diagnosing hypertension early is for every person is to go to one of the drug store outlets in a shopping mall once per year or every 6 to 8 months to determine what the blood pressure is. If it is more than 140/90 in the elderly (older than 80 years) or 120/80 in the rest of us, you may have high blood pressure and should see your physician for further clarification (Ref.1).
2. JS Trilling et al. Arch Fam Med 2000 Sep/Oct (9): 794-801.
3. DJ Hyman et al. Arch Intern Med 2000 Aug 160(15): 2281-2286.
4. CP Tifft Curr Hypertens Rep 2000 Jun (3): 243-246.
5. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 199.
6. Noble: Textbook of Primary Care Medicine, 3rd ed.,2001, Mosby Inc.
7. Goroll: Primary Care Medicine, 4th ed., 2000, Lippincott Williams & Wilkins
8. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
9. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier