Hypertension and shortness of breath: what to know

Breathlessness has many possible explanations, including asthma, a chest infection, anaemia, an abnormal heart rhythm, or a heart or lung problem. A blood pressure reading alone cannot identify the cause.

Persistently raised pressure makes the heart work harder. Over time, this can affect how well the heart relaxes or pumps, allowing fluid to build up in the lungs and causing breathlessness, sometimes worse when lying flat or during activity.

A sudden, very high reading with breathing difficulty may signal a serious problem rather than an ordinary symptom of hypertension. A lower reading after rest does not explain away troubling symptoms.

Other conditions can present with shortness of breath. Wheezing may occur with asthma or COPD; fever and cough can occur with acute bronchitis; palpitations may accompany atrial fibrillation; and chest pressure can occur with angina.

Stop strenuous activity and sit upright if you are breathless. If you have a home monitor, repeat the blood pressure measurement after resting quietly, using the correct cuff and keeping your arm supported. Record the reading, your symptoms, and any medicines taken.

Continue prescribed blood-pressure treatment unless a clinician tells you to change it. Do not take an extra dose to correct a reading or stop treatment because the number improves. Arrange a clinical assessment if breathlessness is new, recurring, or limiting normal activity.

Seek emergency help immediately for severe or rapidly worsening breathlessness, inability to speak in full sentences, blue or grey lips, fainting, confusion, or severe chest pain. Do not drive yourself if you feel seriously unwell.

Urgent assessment is also needed when breathlessness comes with new weakness, numbness, difficulty speaking, a severe headache, vision change, coughing pink or frothy fluid, or a markedly high blood-pressure reading.

Ask what may be causing the breathlessness, whether your blood pressure treatment needs review, and whether you need heart or lung tests. Tell the clinician when symptoms began, what brings them on, whether they occur at rest or when lying down, and which readings you have recorded.