Severe hypertension: symptoms and urgent action

Hypertension often causes no noticeable symptoms, but persistently raised pressure strains artery walls and makes the heart work harder. Over time, this can contribute to heart failure, kidney disease, stroke, transient ischaemic attack, angina, and eye complications. Obesity and obstructive sleep apnoea can make blood pressure harder to control, although severe readings can occur for other reasons too.

One high reading is not enough to explain the whole situation. Sit quietly, use a correctly fitted cuff, and repeat the measurement according to local medical advice. Record the readings, timing, symptoms, and prescribed medicines.

If you feel well, repeat the reading after resting and contact your healthcare service promptly for advice about the result. Take prescribed blood-pressure medicine exactly as directed; do not double a dose or stop treatment because of one reading unless a clinician tells you to. Avoid exertion while you are seeking advice and bring your medication list to an assessment.

Call emergency services for chest pain, severe breathlessness, sudden weakness or numbness, difficulty speaking, confusion, fainting, a severe unusual headache, or sudden vision change with a very high reading. These symptoms may signal stroke, heart strain, or another acute complication and should not be monitored at home.

Ask how to measure at home, whether your medicines need adjustment, whether sleep apnoea or kidney disease should be assessed, and what reading or symptom should trigger emergency action.