Can High Blood Pressure Cause Shortness of Breath?

What is Blood Pressure?

Blood pressure refers to the force of the blood against the walls of your arteries as it moves through the body.1 This also relates to your heart, as blood pressure is caused by the heart pumping blood from the lungs and the heart to the body.2 

For this reason, blood pressure is highest with systolic pressure as systole refers to the heart contracting to pump blood, increasing blood pressure. Blood pressure decreases with diastole as the heart muscle relaxes and so diastolic pressure is lower.3

How is Blood Pressure Measured?

Blood pressure is measured with a blood pressure machine. The measurement itself is displayed as millimetres of mercury (mmHg). These machines often have a cuff attached to them which is used to measure blood pressure. The cuff is wrapped around the upper part of the arm, above the heart, and filled with air so that the cuff is tight around the arm. There are sensors in the arm cuff that pick up automatic signals and display the results on a screen.4

It is displayed as two numbers11:

  • The top number is systolic pressure. Normal systolic pressure is usually below 120 mmHg.
  • The bottom number is the diastolic pressure. Normal diastolic pressure is usually below 80 mmHg.

Blood pressure machines also often monitor your heart rate. This is the number of times your heart beats in 1 minute. Most adults have a resting heart rate of between 60 to 100 bpm, meaning beats per minute.14 

Pressure in the Two Halves of the Heart

The pressure on the right side of the heart is typically lower than on the left side. This is because the right side of the heart only pumps deoxygenated blood from the heart to the lungs. On the other hand, the left side of the heart, specifically called the left ventricle, pumps oxygenated blood from the heart, after circulating through the lungs, to the rest of the body and meets resistance from muscles, arteries and peripheral areas while the blood is flowing. 

Therefore the pressure is higher on the left side as this side has more resistance to blood flow and a more difficult job, called a workload.6 This refers to the increased distance the blood must travel in comparison to the right side of the heart.5

How High is “High” Blood Pressure?

High blood pressure is considered as readings over 140/90 mmHg. However, you are seen as being at risk of developing high blood pressure if your reading is between 120/80 mmHg and 140/90 mmHg.11

It is important to note that after exercise, or the stress associated with the blood pressure test and hospital environments, your blood pressure reading may be seen as higher than it should be. This does not necessarily mean you have high blood pressure and need treatment. When this occurs, a reading from both arms is taken, or the patient can be invited to return for another reading once they have relaxed.

What is Pulmonary Hypertension?

The word ‘pulmonary’ refers to the lungs. Therefore, pulmonary hypertension is high blood pressure in the arteries connected to the lungs that supply blood to the lung. These are called the pulmonary arteries, and they become thicker and stiffer with hypertension so they cannot expand properly to allow blood to flow as easily. Over time, the blood vessels can become damaged.7 This condition damages the right side of the heart, which is serious as this half is responsible for carrying deoxygenated blood to the lungs. If left untreated for a long duration, this condition can lead to heart failure.8

Can High Blood Pressure Cause Shortness of Breath?

High blood pressure, and high blood pressure specifically affecting the pulmonary arteries, can cause shortness of breath known as dyspnea and is one of the first symptoms of pulmonary hypertension. As the arteries connected to the lungs in pulmonary hypertension become thicker and stiffer, the blood flow increases resistance. This makes it difficult for the heart to pump blood to the lungs, and the right side of the heart must work harder.12

Other Possible Causes of Shortness of Breath

Other causes of shortness of breath can include9:

  • Asthma, COPD (chronic obstructive pulmonary disorder) and emphysema
  • Lung infections such as bronchitis or tuberculosis
  • Lung cancer or tumours within the lung
  • Blood clots in the lung or pulmonary embolism.
  • Heart Failure. 

Other Signs and Symptoms of High Blood Pressure

High blood pressure often doesn’t have symptoms and is only identified by a blood pressure test. However, some of the signs and symptoms that are experienced by some patients include10:

  • Blurred vision
  • Headache
  • Dizziness
  • Nosebleeds

Risk Factors for High Blood Pressure

Risk factors for high pressure can include11:

  • Being overweight
  • Age - As you get older your risk of high blood pressure increases
  • Smoking or excessively drinking alcohol
  • An unhealthy diet rich in saturated fats, salt, and sugars
  • A lack of exercise
  • Diabetes
  • Family history and/or genetics
  • Ethnicity - African Americans have an increased risk

Treatment, Management, and Prevention of High Blood Pressure

Treatment

Several medications can treat high blood pressure.10

Figure: Medications for managing blood pressure

Created by Aastha Malik

These are prescribed along with lifestyle changes. These lifestyle changes can also be adopted by people wanting to prevent high blood pressure. 

Prevention

Some of the methods you can use to reduce the likelihood of developing high blood pressure or prevent it from getting worse include10:

Figure: Prevention of high blood pressure

Created by Aastha Malik

Management

To manage high blood pressure, you should take readings of your blood pressure regularly and record them. This is important to keep your GP informed of your blood pressure and can help you and your doctor recognise if your actions have improved your symptoms. For extra support and queries, you can access the British Heart Foundation’s HealthUnlocked Community

When to Call a Doctor or Dial 999

If you have taken a blood pressure test and have a blood pressure reading over 180/120 mmHg and you also have symptoms such as13:

  • Chest pain
  • Difficulty speaking or breathing
  • Numbness or weakness
  • Changes in vision
  • Severe headaches

You should call a doctor or ring 999 immediately. If you have the symptoms and cannot take a blood pressure test, it is advisable to ring 111. These symptoms can indicate organ damage from high blood pressure. When you reach the emergency room, you may be asked some questions so you can receive better treatment. You may want to prepare an answer to these question examples below. Examples of these questions may include13:

  • Are you currently on any medication for high blood pressure? / have you forgotten to take your blood pressure medication?
  • What are your current symptoms?
  • How long have you been experiencing these symptoms?

Summary

High blood pressure is common and often has no symptoms in the early stages, so it is important to have your blood pressure checked regularly, especially if you have known risk factors or are over the age of 40. Shortness of breath is a relatively common symptom of high blood pressure and pulmonary hypertension. Still, there are other signs and symptoms to look out for, such as nosebleeds and chest pain. 

To protect yourself and your family, it is important to take preventative steps such as increasing how often you exercise, cutting back on unhealthy foods,  alcohol and smoking, as well as increasing your intake of fruits and vegetables. 

Managing your condition if you already suffer from high blood pressure is important. You should do this with regular blood pressure checks and healthy lifestyle changes. With lifestyle changes and medications, patients with high blood pressure can reduce their symptoms and live long and healthy lives. Most importantly, remember you are not alone, and there are support services and guides available. Some of these are linked below:

References

  1. High Blood Pressure. Medline [Internet]; 2020. Available from: https://medlineplus.gov/highbloodpressure.html
  2. What is blood pressure? NHS [Internet]; 2019. Available from: https://www.nhs.uk/common-health-questions/lifestyle/what-is-blood-pressure/ 
  3. Systole. Britannica [Internet]; 2020. Available from: https://www.britannica.com/science/systole-heart-function 
  4. Blood pressure test. NHS [Internet]; 2021. Available from: https://www.nhs.uk/conditions/blood-pressure-test/ 
  5. Pressures of Blood Flow Within the Heart. Children’s Heart Federation [Internet]. Available from: https://chfed.org.uk/documents/2014/12/pressures-within-the-heart-factsheet-2.pdf/ 
  6. Berman MN, Tupper C, Bhardwaj A. Physiology, Left Ventricular Function. StatPearls [Internet]; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541098/ 
  7. Pulmonary hypertension. NHS.  [Internet]; 2020. Available from: https://www.nhs.uk/conditions/pulmonary-hypertension/
  8. Pulmonary Hypertension. Cleveland Clinic [Internet]. Available from: https://my.clevelandclinic.org/health/diseases/6530-pulmonary-hypertension-ph 
  9. Bozkurt B, Mann DL. Shortness of Breath. Circulation [Internet]; 2003; 108(2):e11-3. Available from: https://www.ahajournals.org/doi/full/10.1161/01.cir.0000075956.36340.78 
  10. High Blood Pressure - symptoms and treatment. British Heart Foundation [Internet]. Available from: https://www.bhf.org.uk/informationsupport/risk-factors/high-blood-pressure/symptoms-and-treatment 
  11. High Blood Pressure and Older Adults. National Institute of Ageing [Internet]; 2021. Available from: https://www.nia.nih.gov/health/high-blood-pressure-and-older-adults
  12. Why Does Pulmonary Hypertension Cause Shortness of Breath? Michigan Health [Internet]; 2017. Available from:  https://healthblog.uofmhealth.org/heart-health/why-does-pulmonary-hypertension-cause-shortness-of-breath
  13. High Blood Pressure: When to Seek Emergency Care. Cleveland Clinic [Internet]; 2021. Available from: https://my.clevelandclinic.org/health/articles/16563-high-blood-pressure--when-to-seek-emergency-care
  14. How do I check my pulse? NHS [Internet]; 2021. Available from: https://www.nhs.uk/common-health-questions/accidents-first-aid-and-treatments/how-do-i-check-my-pulse/

Support Services

  1. Blood Pressure UK; 2021. Available from: https://www.bloodpressureuk.org/ 
  2. Living with High Blood Pressure. Health Unlocked  [Internet]; 2022. Available from: https://healthunlocked.com/programs/high-blood-pressure 
  3. Overview. High Blood Pressure. NHS [Internet]; 2019. Available from: https://www.nhs.uk/conditions/high-blood-pressure-hypertension/ 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Laura Preece

BSc Pharmaceutical Sciences and MRes Pharmacy and Pharmaceutical Sciences
I am a researcher and medical writer with a passion for pharmaceutics, disease and biological sciences. I am currently researching cellular and molecular biology, investigating the use of vitamin C as an adjunctive therapy for diabetes mellitus.

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