Mildly elevated blood pressure often goes unnoticed by patients. Symptoms such as headaches, dizziness, exhaustion, and nausea usually occur only in cases of severe hypertension with blood pressure values around 200 mmHg. This section explains the possible consequences of elevated blood pressure.
Even when hypertension causes no symptoms, it is a serious disease. Untreated hypertension can lead to life-threatening damage to the heart, blood vessels, eyes, and kidneys.
High Blood Pressure Can Cause Heart Failure
The higher the blood pressure, the harder the heart must work to pump blood into the arteries. Over time, the heart muscle adapts to this increased workload by becoming thicker. However, the muscle gradually loses elasticity and becomes stiff.
At the same time, blood supply through the coronary arteries does not increase sufficiently to provide the enlarged heart muscle with enough oxygen and nutrients. As a result, heart muscle weakness or heart failure (cardiac insufficiency) develops.
Initially, heart failure causes shortness of breath (dyspnea) during physical exertion.
If you need to stop while climbing stairs because of shortness of breath, you should consult your physician for further evaluation.
Diagnostic Evaluation
The diagnostic evaluation includes:
Clinical examination may reveal enlargement of the heart.
Because of the increased workload, blood may back up into the lungs. Fluid can leak from the pulmonary blood vessels.
In advanced stages, shortness of breath may occur even at rest. Symptoms often worsen when lying down and may lead to:
Reduced pumping function of the left ventricle may cause pulmonary congestion and cardiogenic pulmonary edema (“water in the lungs”).
When listening to the lungs, crackling sounds may be heard. Pleural effusions (fluid accumulation between the lungs and chest wall) and edema in the legs may also develop.
Additional diagnostic tests include:
High Blood Pressure Can Cause Arteriosclerosis
Hypertension is one of the most important risk factors for arteriosclerosis (atherosclerosis).
Persistently elevated pressure damages the walls of blood vessels. In these damaged areas, blood fats, calcium, and other blood components may accumulate.
This can lead to narrowing of the arteries (stenosis).
As a result, organs and tissues such as:
may no longer receive adequate oxygen and nutrients.
Possible consequences include:
High Blood Pressure Can Damage the Kidneys
The kidneys contain tiny vascular structures called glomeruli, where primary urine is filtered from the blood.
High blood pressure is especially harmful to these delicate blood vessels.
If hypertension is combined with diabetes mellitus, the kidneys are at even greater risk.
Elevated pressure in the glomerular vessels gradually impairs kidney function.
Waste products that are normally excreted in the urine can no longer be adequately filtered from the blood.
The glomerular vessels may also become permeable to larger molecules, resulting in protein loss through the urine (proteinuria).
In end-stage kidney failure, renal replacement therapy such as dialysis becomes necessary.
High Blood Pressure Can Damage the Eyes
High blood pressure is also harmful to the small blood vessels of the eyes.
During ophthalmologic examination, signs of blood pressure–related retinal damage are often detected even when hypertension has only recently been diagnosed or has not yet been recognized.
This condition is called hypertensive retinopathy.
Symptoms usually occur late and may include:
Retinal changes caused by elevated blood glucose levels are called diabetic retinopathy.
Combination of Hypertensive and Diabetic Retinopathy
The combination of:
is particularly dangerous and may ultimately lead to blindness.
Literature References
World Health Organization (WHO). Hypertension