Hypertension (high blood pressure) can lead to dangerous complications, but it typically doesn’t cause noticeable symptoms. Most people don’t know they have it until they are diagnosed. Hypertension affects up to 50% of American adults.

Blood pressure is the force of blood in the arteries. Too much force leads to injured and weakened blood vessels. Scar tissue can lead to atherosclerosis, in which fat and cholesterol build up and form plaques—clusters that impede blood flow. Complications of hypertension can be dangerous or fatal.

1. Heart Disease

Heart disease, or cardiovascular disease (CVD), is any disease affecting the heart or blood vessels due to the effects of blood pressure and atherosclerosis. CVD is a leading cause of death in the United States.

Hypertension can affect the heart in the following ways:

• Narrowing and damaging the arteries supply blood to the heart
• Straining the heart, which leads to a thickening of the heart’s pumping chamber
• Reducing blood flow to the heart muscle 

2. Heart Failure  

Heart failure occurs when the heart isn’t pumping well and cannot supply enough blood to the body. It can occur quickly or gradually over many years. 

3. Stroke

A stroke occurs when part of the brain does not have enough blood flow due to a blockage or bleeding in the brain. Hypertension can significantly raise the risk of a stroke because it affects the arteries that supply blood to the brain.

Strokes can cause severe brain damage and are fatal in some instances. This is because the brain doesn’t receive enough oxygen or vital nutrients. Stroke damage is sometimes permanent.

4. Aneurysm

An aneurysm is a bulge in the wall of an artery. It can occur when hypertension causes weak areas in the arteries. An aneurysm can rupture and bleed, which can be fatal. Aortic aneurysms occur in the large artery that carries blood from the heart to much of the body. A cerebral aneurysm occurs in the arteries of the brain, causing a stroke if it ruptures.

5. Cognitive Decline

Unmanaged hypertension can increase the risk of cognitive decline or impairment (a reduction in thinking abilities such as memory, attention, problem-solving, and decision-making).

Hypertension-related conditions that lead to cognitive impairment include:

Researchers are unsure how hypertension leads to cognitive impairments. However, they suspect that hypertension can cause damage to the brain and its blood vessels.

6. Kidney Disease

High blood pressure is the second most common cause of kidney failure in the United States. It can weaken and narrow the kidneys’ blood vessels. 

When the kidneys are damaged, it is harder for them to remove waste and fluid from the body. Fluid that the body cannot get rid of can raise blood pressure and lead to health problems. 

7. Peripheral Artery Disease

Peripheral artery disease (PAD) occurs when narrowed arteries reduce blood flow in the arms or legs. It can affect any blood vessel but is more common in the legs. PAD can lead to life-threatening infections and amputation.

8. Vision Impairment

Hypertension can damage blood vessels anywhere in the body, including the eyes. When the blood vessels of the eyes are damaged, there is reduced blood flow and even ruptures—a condition called hypertensive retinopathy.

Hypertensive retinopathy can lead to bleeding, blurred vision, vision loss, aneurysm, glaucoma (high pressure in the eye damages the optic nerve), or age-related macular degeneration (damage to an area of the light-sensitive retina in the back of the eye).

Who Is at Risk for Hypertension Complications?

Various risk factors increase the risk of hypertension and complications related to the condition. These include:

• Health conditions: Kidney disease, diabetes, mood disorders, and stress can elevate blood pressure, and hypertension can worsen these conditions. Research also shows people who live with painful inflammatory conditions, neuropathy (damage to nerves), and migraines may also experience persistent blood pressure elevations.
• Lifestyle factors: A high-sodium diet or a sedentary lifestyle (little physical activity) can lead to high blood pressure.
• Certain behaviors: Smoking and drinking alcohol can increase blood pressure.
• Family history: If one parent or another close relative has high blood pressure, your risk for hypertension is higher.
• Older age: As people age, their blood vessels lose elasticity, which can increase blood pressure. However, hypertension can also affect younger adults and children. 
• Sex: Men have higher rates of hypertension until age 64, after which women are more likely to have the condition.

Certain racial and ethnic groups, including people who are Black, Hispanic, and Asian, have higher rates of hypertension. Black people also have a higher risk for complications of hypertension than any other group. One of the most significant reasons is healthcare inequalities, including racial bias from medical providers and reduced access to treatment and care.

How to Prevent Hypertension-Related Complications

The Importance of Monitoring Hypertension

Regular blood pressure readings are crucial for managing hypertension. The American Heart Association considers a “normal” reading to be less than 120/80 millimeters of mercury (mmHg).

By monitoring your blood pressure, you can update your healthcare provider on your numbers, and they can help you work to prevent complications. However, home monitoring does not replace regular healthcare provider visits.

Work With a Healthcare Provider

Managing your blood pressure starts with working with your healthcare provider. Your provider can help you work toward a healthy lifestyle that reduces your blood pressure and lowers your risk for hypertension complications. They may also prescribe medications.

Your provider can also help you manage health conditions affecting blood pressure. Awareness of the signs and symptoms of heart disease is vital. Discuss your specific risk factors with your healthcare provider and what you can do to manage them. 

Lifestyle Changes

Lifestyle changes can help you to manage your blood pressure levels. Such changes include:

• A heart-healthy diet: Eating a heart-healthy diet can help manage your blood pressure numbers and reduce your risk for heart complications. The best foods for heart health are rich in nutrients, low in unhealthy fats, and high in fiber.
• Healthy weight: If you are overweight or obese, your heart must work harder to pump blood and oxygen. Maintaining a healthy weight can reduce stress on your heart, manage your blood pressure, and reduce your risk for complications of hypertension.
• Not smoking: Smoking damages blood vessels, which can increase blood pressure and your risk for heart attack and stroke.
• Physical activity: Physical activity is vital to keeping your heart and blood vessels strong. It can also be good for your overall health and help you maintain a healthy weight.
• Sleeping well: Aim to get seven to nine hours of sleep every night. Less can affect your blood pressure and overall health. Let your healthcare provider know you are having trouble sleeping. If you have been diagnosed with a sleep disorder, work to manage it.

Medication When Necessary

Even with lifestyle changes, you may still need medication to keep your blood pressure at healthy levels. There are many different classes of blood pressure medicines for managing this. 

Blood pressure medications work to:

• Rid the body of fluid to get your water and salt levels at normal ranges.
• Relax blood vessels.
• Get the heart to beat with less force.
• Block nerve activity that restricts blood vessels.

Take your blood pressure medications as prescribed. Do not stop taking them without talking to your healthcare provider.

When to See a Provider

Uncontrolled hypertension can lead to symptoms that can affect you daily. Elevated blood pressure can cause blurry vision, severe fatigue, irregular heartbeat, and nosebleeds. Let your healthcare provider know if you are experiencing any of these symptoms.

A blood pressure of 180/120 mmHg is considered dangerously high. If your blood pressure gets this high, wait a few minutes and check it. If it is still high or you experience more severe symptoms like breathing troubles, chest pain, numbness and weakness, vision changes, and difficulty talking, call 911 or have someone take you to the nearest emergency department. 

Contacting your healthcare provider is also a good idea if regular home monitoring shows that your blood pressure is still high, even with lifestyle changes and medications. 

Summary 

High blood pressure can lead to serious complications if you do not manage it properly. Dangers of hypertension include heart disease, stroke, kidney disease, vision impairment, and cognitive problems. Many of these are the result of blood vessel damage, which can affect blood flow to the heart, brain, and other body areas. 

Work with your healthcare provider to manage your blood pressure numbers and reduce complications. Blood pressure management requires monitoring levels, lifestyle changes, and sometimes, medication. 

If your blood pressure is too high and you experience severe symptoms like chest pain and trouble breathing, get emergency care. You could also let your healthcare provider know if your blood pressure is still high despite lifestyle changes and medications.