Key Takeaways
- Hypertension (high blood pressure) can make you feel tired and fatigued, especially when your blood pressure is severely elevated.
- High blood pressure can cause tiredness and fatigue due to cardiovascular stress, reduced blood circulation, and complications like an enlarged heart, kidney disease, or sleep apnea.
- Even so, the vast majority of people with hypertension have no symptoms, even when their blood pressure is severely elevated.
Hypertension (high blood pressure) can contribute to feelings of tiredness and fatigue due to cardiovascular stress and complications such as kidney disease or an enlarged heart. Though most people with hypertension don’t have symptoms, fatigue, dizziness, and other symptoms can start to develop when the blood pressure is severely—and sometimes dangerously—elevated.
Verywell / Dennis Madamba
How High Blood Pressure Makes You Tired
High blood pressure is often referred to as the “silent killer” because most people do not experience any noticeable symptoms. However, when blood pressure becomes severely elevated, it can lead to changes in the body that may cause daytime fatigue and tiredness.
Generally speaking, the more severely elevated your blood pressure is, the more likely you are to experience symptoms like tiredness and fatigue.
Among some of the contributing factors:
- Heart strain: When you have high blood pressure, your heart has to work harder to pump blood through the body. In the same way that strenuous exercise forces the heart to work harder, leading to physical exhaustion, hypertension can do the same without strenuous exertion.
- Reduced blood flow: High blood pressure is closely linked to atherosclerosis, in which arteries harden and narrow. This reduces the amount of blood and oxygen delivered to the lungs and other organs, leaving you exhausted even with minimal exertion.
- Enlarged heart: When the heart is forced to work hard for many years, the heart muscle itself will start to thicken and grow larger, leading to a condition called cardiomegaly. This can lead to complications like heart valve disease and heart failure, both of which can reduce the amount of blood delivered to organs and tissue.
- Kidney disease: High blood pressure can strain the kidneys, potentially leading to damage over time. This can reduce their ability to filter waste, causing a buildup of toxins such as urea in the blood. A buildup of these toxins can lead to symptoms like fatigue, tiredness, and brain fog, which are common in conditions like uremia (high blood urea).
- Sleep apnea: High blood pressure can cause fluid retention as blood circulation is decreased. This can contribute to obstructive sleep apnea (OSA) as tissues of the throat, overloaded with fluid, are more likely to collapse during sleep. The disruption of sleep can leave a person feeling tired and fatigued throughout the day.
- Chronic stress: When you’re stressed, your body releases a hormone called cortisol. This hormone can constrict blood vessels as part of the fight-or-flight response. Chronic stress may keep blood pressure and heart rate elevated for extended periods, potentially disrupting sleep patterns and the body’s natural ability to regulate blood pressure.
- Medication side effects: Certain medications used to treat hypertension, including diuretics (“water pills”) and beta-blockers, can cause fatigue as a side effect. Diuretics do so by causing an imbalance in electrolytes due to increased urination, while beta-blockers do so by slowing the heart rate as well as the delivery of oxygen to tissues.
When Does Hypertension Cause Symptoms?
Hypertension is diagnosed when blood pressure readings are consistently at or above 130/80 mmHg. The severity of hypertension is described in stages, with the risk of symptoms generally increasing with each advancing stage.
| Systolic (upper) blood pressure | Diastolic (lower) blood pressure | ||
| Normal | Less than 120 | and | Less than 80 |
| Elevated | 120–129 | and | 80 or less |
| Stage 1 (mild) | 130-139 | or | 80-89 |
| Stage 2 (moderate) | 140 or more | or | 90 or more |
| Stage 3 (hypertensive crisis) | More than 180 | and/or | More than 120 |
While it is possible to experience symptoms during Stages 1 and 2, a great many people with mild to moderate hypertension have no symptoms at all. Even with severe hypertension, as many as 60% of people experience no notable symptoms.
With that said, an older study from the Centers for Disease Control and Prevention (CDC) reported that the majority of emergency room visits were for people with a systolic blood pressure reading of 160 or higher and/or a diastolic blood pressure reading of 100 or higher, suggesting that this may be the threshold at which symptoms are more common.
What Are Other Possible Symptoms of Hypertension?
On their own, fatigue and tiredness can be caused by many different things and are not diagnostic of hypertension. However, fatigue and tiredness may point to severe hypertension as a cause if they occur with other tell-tale signs and symptoms, including:
When to Seek Emergency Care
Stage 3 hypertension, also known as a hypertensive crisis, is characterized by a sudden, dangerous spike in blood pressure. A hypertensive crisis is diagnosed when the systolic blood pressure is 180 mmHg or higher and/or the diastolic blood pressure is 120 mmHg or higher.
A hypertensive crisis is a medical emergency. Without appropriate treatment, it can lead to death in around 79% people within one year. This is due to the damage it can inflict on vital organs, leading to potentially life-threatening complications like heart attack, acute heart failure, aortic dissection, and acute kidney failure.
It is important, therefore, to call 911 if you or someone you know has signs of a hypertensive crisis, including:
- A sudden, severe headache
- Difficulty breathing or catching one’s breath
- Sudden, severe pain in your abdomen, chest, or back
- Sudden numbness or weakness
- A sudden change in vision
- Problems speaking
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