High Blood Pressure Can Damage Your Heart for Years Without Warning

Arterial Hypertension: Why High Blood Pressure Should Not Be Ignored

Arterial hypertension is one of the most common cardiovascular conditions. Its main danger is that elevated blood pressure can remain virtually symptom-free for years while gradually damaging the heart, blood vessels, kidneys, and other organs. According to the World Health Organization, in 2024 approximately 1.4 billion adults aged 30–79 years were living with hypertension. At the same time, around 44% of people with hypertension were unaware that they had the condition. This is why monitoring blood pressure is important even when you feel perfectly well.

What is arterial hypertension?

Blood pressure reflects the force exerted by circulating blood against the walls of the arteries. According to the 2024 European Society of Cardiology (ESC) Guidelines, arterial hypertension is defined as persistent office blood pressure of 140/90 mmHg or higher.

However, the diagnosis is usually not based on a single measurement. A physician may recommend repeated measurements, home blood pressure monitoring, or 24-hour ambulatory blood pressure monitoring. The 2024 ESC Guidelines also define a category of elevated blood pressure as office systolic blood pressure of 120–139 mmHg and/or diastolic blood pressure of 70–89 mmHg. These values do not yet meet the criteria for hypertension but warrant assessment of the patient’s overall cardiovascular risk. Blood pressure readings should always be interpreted individually, taking into account age, coexisting conditions, risk factors, and overall cardiovascular risk.

Why does hypertension develop?

In most cases, there is no single identifiable cause. Several factors may contribute to elevated blood pressure at the same time:

• genetic predisposition;

• excess body weight;

• low levels of physical activity;

• excessive salt intake;

• smoking;

• excessive alcohol consumption;

• chronic stress;

• insufficient sleep;

• diabetes mellitus;

• kidney disease;

• metabolic disorders;

• age-related changes in the blood vessels.

The more risk factors a person has, the more important it becomes to monitor blood pressure regularly and assess cardiovascular health.

What symptoms can occur with high blood pressure?

One of the main characteristics of hypertension is that it often causes no obvious symptoms. A person may feel completely well while having persistently elevated blood pressure. When blood pressure rises significantly or complications develop, symptoms may include:

• headache;

• dizziness;

• weakness;

• shortness of breath;

• rapid or irregular heartbeat;

• chest pain or discomfort;

• visual disturbances;

• reduced exercise tolerance.

However, these symptoms are not specific to hypertension.

You should not rely solely on how you feel. The most reliable way to know your blood pressure is to measure it.

Why is high blood pressure dangerous for the heart?

When blood pressure remains persistently elevated, the heart has to work against greater resistance. Over time, this can lead to structural changes in the heart muscle and blood vessels and increase the risk of cardiovascular complications.

Uncontrolled hypertension increases the risk of:

• myocardial infarction;

• stroke;

• heart failure;

• certain cardiac arrhythmias;

• chronic kidney disease;

• damage to the blood vessels of the eyes.

For this reason, timely diagnosis and regular blood pressure monitoring are extremely important.

How should blood pressure be measured correctly at home?

Proper measurement technique helps obtain more reliable results. Before measuring your blood pressure, sit quietly for approximately 5 minutes. Your back should be supported, your feet should be flat on the floor and uncrossed, and the arm with the cuff should be positioned approximately at heart level. For home monitoring, a validated automatic blood pressure monitor with an appropriately sized cuff should be used. It is generally recommended to take two measurements, 1–2 minutes apart, in the morning and evening.

For an initial assessment of home blood pressure, measurements should preferably be taken over several days, ideally for approximately 7 days, with the results recorded. A blood pressure diary helps the physician assess blood pressure levels and evaluate the effectiveness of treatment. In some cases, a cardiologist may recommend 24-hour ambulatory blood pressure monitoring (ABPM).

How is arterial hypertension diagnosed?

The assessment of a patient with elevated blood pressure begins with confirmation of the blood pressure level, evaluation of overall cardiovascular risk, and assessment for possible target-organ damage.

Depending on the patient’s condition, the physician may recommend:

• repeated blood pressure measurements;

• home blood pressure monitoring or 24-hour ABPM;

• electrocardiography (ECG);

• echocardiography;

• blood and urine tests;

• measurement of blood glucose and lipid levels;

• assessment of kidney function;

• assessment of albuminuria;

• additional investigations when clinically indicated.

The purpose of the evaluation is not only to confirm the presence of hypertension but also to determine overall cardiovascular risk, identify possible causes of elevated blood pressure, and assess the condition of target organs.

Can hypertension be controlled?

Yes. In most cases, blood pressure can be effectively controlled. A physician may recommend lifestyle changes and, when necessary, antihypertensive medication.

The following measures are particularly important:

• reducing excess body weight;

• engaging in regular physical activity;

• limiting salt intake;

• maintaining a balanced diet;

• stopping smoking;

• limiting alcohol consumption or avoiding it altogether;

• getting adequate, high-quality sleep;

• monitoring blood cholesterol and glucose levels;

• measuring blood pressure regularly.

If a patient has already been prescribed blood pressure-lowering medication, they should not stop taking it on their own once their blood pressure returns to normal. Normal blood pressure while receiving treatment often means that the therapy is working. Any changes to the medication or its dosage should only be made after consultation with the treating physician.

When should you see a cardiologist?

A medical consultation is recommended if:

• blood pressure is repeatedly elevated;

• blood pressure readings have become higher than usual;

• palpitations or irregular heartbeats occur;

• shortness of breath develops;

• chest pain or discomfort occurs;

• physical activity becomes more difficult to tolerate;

• hypertension has already been diagnosed but blood pressure remains unstable;

• previously prescribed treatment no longer controls blood pressure adequately.

There is no need to wait for pronounced symptoms to develop. The earlier cardiovascular risk factors and target-organ damage are identified, the sooner appropriate measures can be taken to control them.

When is urgent medical attention required?

If blood pressure is very high, particularly ≥180/120 mmHg, it should be measured again after several minutes of rest. If the blood pressure remains this high, medical attention should be sought.

If very high blood pressure is accompanied by:

• severe chest pain or significant chest discomfort;

• severe shortness of breath;

• sudden weakness or numbness of the face, arm, or leg;

• speech disturbance;

• sudden deterioration of vision;

• loss of consciousness;

• any other sudden and severe symptoms,

emergency medical assistance should be called immediately.

Do not wait until high blood pressure starts causing symptoms

Arterial hypertension can remain asymptomatic for a long time. Regular blood pressure monitoring is therefore one of the simplest ways to detect the problem early and reduce the risk of cardiovascular complications. If you notice repeated elevations in your blood pressure or would like to assess your cardiovascular health, consult a cardiologist at AKFA Medline University Hospital. For an initial assessment of home blood pressure, measurements should preferably be taken over several days, ideally for approximately 7 days, with the results recorded. A blood pressure diary helps the physician assess blood pressure levels and evaluate the effectiveness of treatment. In some cases, a cardiologist may recommend 24-hour ambulatory blood pressure monitoring (ABPM).

How is arterial hypertension diagnosed?

The assessment of a patient with elevated blood pressure begins with confirmation of the blood pressure level, evaluation of overall cardiovascular risk, and assessment for possible target-organ damage.

Depending on the patient’s condition, the physician may recommend:

• repeated blood pressure measurements;

• home blood pressure monitoring or 24-hour ABPM;

• electrocardiography (ECG);

• echocardiography;

• blood and urine tests;

• measurement of blood glucose and lipid levels;

• assessment of kidney function;

• assessment of albuminuria;

• additional investigations when clinically indicated.

The purpose of the evaluation is not only to confirm the presence of hypertension but also to determine overall cardiovascular risk, identify possible causes of elevated blood pressure, and assess the condition of target organs.

Can hypertension be controlled?

Yes. In most cases, blood pressure can be effectively controlled. A physician may recommend lifestyle changes and, when necessary, antihypertensive medication.

The following measures are particularly important:

• reducing excess body weight;

• engaging in regular physical activity;

• limiting salt intake;

• maintaining a balanced diet;

• stopping smoking;

• limiting alcohol consumption or avoiding it altogether;

• getting adequate, high-quality sleep;

• monitoring blood cholesterol and glucose levels;

• measuring blood pressure regularly.

If a patient has already been prescribed blood pressure-lowering medication, they should not stop taking it on their own once their blood pressure returns to normal Normal blood pressure while receiving treatment often means that the therapy is working. Any changes to the medication or its dosage should only be made after consultation with the treating physician.

When should you see a cardiologist?

A medical consultation is recommended if:

• blood pressure is repeatedly elevated;

• blood pressure readings have become higher than usual;

• palpitations or irregular heartbeats occur;

• shortness of breath develops;

• chest pain or discomfort occurs;

• physical activity becomes more difficult to tolerate;

• hypertension has already been diagnosed but blood pressure remains unstable;

• previously prescribed treatment no longer controls blood pressure adequately.

There is no need to wait for pronounced symptoms to develop. The earlier cardiovascular risk factors and target-organ damage are identified, the sooner appropriate measures can be taken to control them.

When is urgent medical attention required?

If blood pressure is very high, particularly ≥180/120 mmHg, it should be measured again after several minutes of rest. If the blood pressure remains this high, medical attention should be sought.

If very high blood pressure is accompanied by:

• severe chest pain or significant chest discomfort;

• severe shortness of breath;

• sudden weakness or numbness of the face, arm, or leg;

• speech disturbance;

• sudden deterioration of vision;

• loss of consciousness;

• any other sudden and severe symptoms,

emergency medical assistance should be called immediately.

Do not wait until high blood pressure starts causing symptoms

Arterial hypertension can remain asymptomatic for a long time. Regular blood pressure monitoring is therefore one of the simplest ways to detect the problem early and reduce the risk of cardiovascular complications. If you notice repeated elevations in your blood pressure or would like to assess your cardiovascular health, consult a cardiologist at AKFA Medline University Hospital.