Apparently if you have high blood pressure you actually get LESS headaches, not more!
In fact you could suffer from up to 50% less according to Heart.org (The myth of symptomatic headaches), though they fail to link the specific article in Neurology.
It’s not all good news though as some researchers have suggested this is due to the high pressure physically damaging the nerve endings in the brain! (As in, "I can’t feel my toes. Is that normal, doctor?"). (See also : High Blood Pressure May Be Buffer Against Headaches.)
So, as many sites agree, headaches are not a sign of high blood pressure. Even the NHS state High blood pressure has no symptoms, cheerily adding that if not treated it can damage your kidneys, heart and brain.
Elsewhere they say up to 30% of people in England may have high blood pressure but be unaware of it, putting them at risk of a heart attack or stroke. (Around 25% in younger people, 50% in older people).
Referring to it as a "silent killer", the NHS will tell you:
The only way of knowing there is a problem is to have your blood pressure measured. (NHS: High blood pressure (hypertension))
Strictly speaking, that is not always true, it’s down to generalisation and semantics. High blood pressure may (or may not) cause the odd headache, but consistently extremely high blood pressure (hypertensive crises) is another matter entirely.
Bear in mind these figures are rough generalisations, mediated by fitness, age, gender, race and any underlying conditions. These relate to consistency, not a one off-reading. Also, the ranges can vary based on research and differing medical opinions. It should be noted that you only need one value in the range to apply, having both just makes it better/worse. These caveats aside, for an average adult:
60/40 or less (hypotension) and you very likely need emergency treatment. I suspect you’ve just been shot by a large calibre rifle and are bleeding to death! (Half) joking aside, there’s actually a lot less information about low blood pressure than high. It should be noted that while low blood pressure is generally good, when BP is very low it can be a sign or result of an underlying condition such as heart failure, dehydration, diabetes, anaemia, autonomic neuropathy or atherosclerosis (clogged arteries).
90/60 or less (hypotension) is too low and may need treatment to bring it back up.
One NHS page, referring to a specific causes of low blood pressure, says that "Depending on what your seated blood pressure is, if your systolic reading falls by between 15 to 30mmHg when you stand up, you may have orthostatic hypotension (postural hypotension)" (NHS hypotension diagnosis). According to Bupa around 10 to 20% of people over age 65 have postural hypotension.
(The affects being light-headedness and flopping to the floor like a sack of jelly when you try to stand up, from what I’ve seen!).
91-119/61-79 Either a little low or you are young and/or fit. (e.g. an athletic person may be be around 110/65). The NHS say there is no need to worry as naturally low blood pressure rarely causes problems or needs treatment.
120/80 (give or take a bit) is the ideal.
121-139/81-89 can be considered pre-hypertension or the high end of normal, if consistently at the high end. You might want to change your lifestyle, exercise more, drink less coffee, eat more healthily. Patient Info suggests that those with high normal values (130-139/85-89 mmHg) should be checked annually. (For older people and those with (known) conditions like diabetes or kidney problems this may be considered a normal range.)
140-179/90-109 OK, that’s stage 1 (140/90) or stage 2 (160/100) hypertension and needs bringing down.
180+/110+ Severe hypertension / hypertensive urgency and into (very) life-threatening hypertensive crisis. I saw one medical slide that (for pediatrics) advised "panic". For adults the recommendation is to seek immediate emergency medical treatment.
200+/130+ Malignant (accelerated) hypertension / hypertensive emergency. You are now firmly in the realms of failing organs as a cause or result and need urgent assessment and immediate treatment to reduce the blood pressure – within minutes to hours. Your body can’t take this, it will kill you.
The first, higher number is the systolic measure (when the heart beats), the second, lower number the diastolic (when the heart relaxes). The pressure is measured in mmHg. Suffice to say the higher your diastolic, the more important it is to seek medical attention. There’s a chart at Blood Pressure UK, or my own, below:
There is also a good guide and chart here: Blood Pressure OK
This site is useful as it also has a handy little ‘Blood Pressure Quick Check’. Enter your readings and it offers a chart and advice, along with a sensible caveat that it’s a guide, go see a read doctor. So for my current BP (pushed up with kidney problems, elevated further at the minute (May 2016) perhaps due the that evil flu doing the rounds in the UK) is around 163/100.*
(*And yes, I do have a lousy headache with it, thank you. Yes, I am on amlodipine. Yes, I probably do need to see my GP immediately if it doesn’t quickly drop again!)
Risks of Hypertension Stage 2 Blood Pressure
There are a myriad of risks associated with the onset of hypertension stage 2. For one, hypertension is a huge risk factor for peripheral arterial disease, chronic kidney disease, aneurysms within the arteries, strokes and basic heart disease.
They do go on to advise that I exercise more (not easy in my condition, but I do a bit), that I eat lots of fruit and veg (check) and reduce my salt intake (check). Elsewhere on the site they say ginger helps, as does rosemary and lavender, and suggest I cut back on my caffeine too.
HOWEVER, please note that herbal remedies like these (and others like garlic, ginkgo, hawthorn and licorice root – and especially St. John’s wort) can be adverse and/or conflict with medications. Always tell your doctor if you are experimenting with herbs!
For extreme hypertension, by the time your blood pressure is this high for any length of time, according to the NHS, you may – in some rare cases – be experiencing any or all of the following :
shortness of breath
blurred or double vision
Other sites, like Everyday Health add :
confusion or other neurological symptoms
chest pain and abnormal heartbeat
back pain (across lungs)
Pretty much, by this time you’ve had severe hypertension so long that it’s causing organ damage. In a related way, for kidney failure, you may be told by doctors you can’t feel it as they poke your back, saying, "see!" Of course if you reply, “"Ow!" the consultant will amend it to, " OK, that’s not good. You’re not going home!"
If you happen to have a decent home blood pressure monitor and notice it rising alarmingly, a telephone call to your GP might well go like this:
Receptionist: "We can fit you in next month. Three weeks OK?"
Patient: "Sooner would be better please, my BP is 160/110"
Receptionist: "I spoke to the doctor, can you get here in an hour?"
If the readings are accurate you’ll either be put on blood pressure tablets immediately* or sent straight to A&E.
*As in, take this prescription to the chemist now, then go for blood tests. See me about in 2/3 weeks.
If you have blood pressure in the range of 185/145 or higher, this is what it feels like – ((In)famous and gory exploding head scene from Scanners, 1981):
Actually it hurts a LOT more than that and while your head won’t explode your brain might, in the form of an aneurysm.
This is what an aneurysm feels like, apparently:
" a sudden agonising headache, similar to a sudden hit on the head, resulting in a blinding pain unlike anything experienced before. A stiff neck. Sickness and vomiting. Pain on looking at light."
Extremely high blood pressure can be all of that, feel worse – if you can imagine that! – and goes on and on and on. Until they lower it or until it kills you… (Starting to wonder if I didn’t have an aneurysm when my own bp passed the 185/145 mark once. That headache felt like I’d been hit in the head with a metal baseball bat. I threw up all the amlodipine and – between stifled screams at the vice-like waves of agony keeping me in the foetal position – kept the ward awake half the night with my dry retching, coughing up blood from torn throat muscles when everything else had long since gone into the bowl. )
With that in mind, if you are in a high-stress job (parenting can come under this!) and/or are getting older, it might well be worth investing in a decent blood pressure monitor. Ignoring cheap tat, prices can range from around £20 upwards, with a good quality one still only being around £55. I use an old but reliable Philips HF305 blood pressure monitor, but if I was going to replace it I’d look at something like the Omron Healthcare M6, or similar. All that’s really needed though is for it to be clinically validated. If you have large upper arms though you may want a bigger cuff size*.
Small cuff : 18-22 cm
Medium cuff : 22-32cm
Large cuff : 32-45cm
Recommended viewing: TED-Ed: How blood pressure works, by Wilfred Manzano
If you have a spare half an hour, I suggest watching this enlightening medical talk on ‘How to Have Healthy Blood Pressure’. Premise is high blood pressure bad, patent drugs to fix it, worse. As he rightly says, rather than treating the blood pressure you need to find and treat it’s underlying cause.