The first symptom of high blood pressure is…?

Mar 14, 2019 | 0 comments

High blood pressure is a global health crisis. The worldwide prevalence of hypertension has soared past 1.39 billion persons, more than 31 percent of all adults.

Take this quiz to see how much you know about high blood pressure.

  1. The most common symptom of high blood pressure is:
    Blurry vision
    All of the above
    None of the above
  2. What can increase your risk of high blood pressure?
    A family history of high blood pressure
    All of the above
  3. At what point is blood pressure considered “high”?
    120 over 80
    130 over 80
    140 over 90
    160 over 120
  4. High blood pressure can cause which of the following?
    Heart attack
    Damage to your brain
    Kidney disease
    Vision loss
    All of the above
  5. Which of the following is true about high blood pressure:
    Once you have it you will always have it
    High blood pressure isn’t such big a deal — everyone has it
    High blood pressure cannot be prevented
    Only the first number is important — it doesn’t matter what the second number is
    All of the above
    None of the above


  1. The most common symptom of high blood pressure is? None of the above. Because it has no obvious symptoms, high blood pressure (hypertension) is often called “the silent killer”. According to the Mayo Clinic, hypertension can silently damage your body over years before any symptoms develop, and in fact, the first symptom could be a stroke or heart attack.
  2. What can increase your risk of high blood pressure? All of the above. Overweight is a contributing factor to hypertension, and so is age. Family history, smoking, excessive alcohol and eating too much salt while at the same time eating too little dietary potassium — not eating enough fresh fruits and vegetables — increases risk.
  3. At what point is blood pressure considered “high”? 130/80. Your blood pressure is considered ‘elevated’ at 120-129/80. Two numbers represent blood pressure. The higher (systolic) number shows the pressure while the heart is beating. The lower (diastolic) number shows the pressure when the heart is resting between beats.  ‘Normal’ blood pressure is 120/80 or below. At this level, researchers have demonstrated a much lower risk of heart disease or stroke. The key to preventing stroke or heart attack from high blood pressure is to KNOW if you have high blood pressure. In the U.S. one in three adults — about 70 million people — have hypertension, but fifty percent don’t have it under control, and about 13 million are not even aware they have the disease.
  4. High blood pressure can cause which of the following? All of the above. According to the World Health Organization (WHO) of the 56.9 million deaths worldwide in 2016, heart disease and stroke are the world’s biggest killers and have remained the leading causes of death globally in the last 15 years. How does hypertension cause all of these problems?

Heart: Uncontrolled hypertension damages and narrows arteries, potentially leading to a stroke, coronary artery disease, enlarged left heart, and heart failure.

Dementia: Vascular dementia can result from narrowing and blockage of the arteries that supply blood to the brain and also from strokes.

Kidney scarring: Leads to inability to filter waste properly and kidney failure, leading to dialysis and/or transplant; scarring can lead to an aneurysm (a bulge in the wall of a blood vessel) which can rupture and cause internal bleeding.

Eyes: Hypertension damages the eye’s blood vessels (retinopathy), leads to fluid build-up, and nerve damage.

Sexual dysfunction: decreased blood flow means difficulty achieving and maintaining an erection and can contribute to vaginal dryness and sexual displeasure in women.

And…hypertension can increase calcium loss, leading to loss of bone density (osteoporosis).

  1. Which of the following is true about high blood pressure? None of the above. You’re not born with hypertension, and you can take steps to control and manage hypertension. However! You need to know.

The WHO notes that hypertension is more prevalent in low-and-middle-income countries, and often remains undiagnosed and untreated.

Researchers suspect there may be hundreds of genes responsible for the regulation of blood pressure and it is possible to develop hypertension and still be active and at a healthy weight, however, Dr. Robin Miller, MD Internal Medicine writes, “Being overweight and/or obese can cause high blood pressure in a variety of ways.  When there is increased weight it takes more pressure to move the blood around the body.  When the weight gain is in the abdominal area there is a greater risk for high blood pressure because this type of fat is more likely to cause the arteries to become thick and stiff. When the pipes (the blood vessels) get stiff it is harder to push the blood through. When it gets hard to move blood around the body there is an increase in adrenalin. This will increase salt retention and further increase blood pressure.”

Global obesity

What western country has even touched the brakes to slow down obesity? Not North America, Australia, New Zealand, and most of Europe. It is especially worrisome in formerly ‘poor nations’ including China, India, and South Asia. The irony does not go unnoted: with a decrease in hunger comes a decrease in activity, a contributing cause for obesity, cardiovascular disease, and hypertension.

Most countries in Latin America, despite an upward trend in general medical care and health in many, are uniformly following the ‘western world’ down the rabbit hole.

Are you an expat with hypertension?

In our adopted home of Cuenca, many expats have arrived bearing the burden of chronic hypertension.

But that is why it’s so important to get your blood pressure checked regularly.

If you are overweight with hypertension, weight loss, regular activity, and changing your diet you may be effective in lowering your blood pressure naturally.

A deficiency of potassium is linked to hypertension — and Ecuador offers a rich variety of potassium-rich vegetables and fruits — besides the reliable banana, enjoy avocados, beets, spinach, white beans (cannellini, black, lima, great northern), and potatoes, plus lots more. The website ‘The World’s Healthiest Foods’ lists foods highest in dietary potassium.

If you’d like some helpful guidance, the DASH eating plan (Dietary Approaches to Stop Hypertension) is a proven plan that can lower blood pressure, reduce cholesterol, and improve insulin sensitivity. It’s a guide to healthy eating, not a “diet” (although many experts will refer to it as the “DASH Diet”).   Click here for a high blood pressure fact sheet from, in English, and in Spanish. Click here for sample menus for healthy eating.

High Potassium Foods


Click here for some delicious low-sodium DASH recipes from

Remember, hypertension does not give you any warning: the first symptom of high blood pressure is often stroke or heart attack.

  • Get your blood pressure checked now and every year  — or more — knowledge is power
  • Get to a healthy weight with deliciously fresh food — cut back on restaurant and processed foods
  • If you currently smoke, just quit that nasty habit – you can do it!
  • Go easy on alcohol
  • Breathe … reduce stress  — try yoga — there are many opportunities here in Cuenca
  • Enjoy regular activity — just walking and breathing and swinging your arms is great.

American Heart Association. Hypertension guidelines, one year later: monitoring the change. Published: Nov 27, 2018
Centers for Disease Control and Prevention. Undiagnosed Hypertension. Updated April 6, 2016.
Cuenca Highlife. What’s Normal? Blood pressure, blood glucose, body temperature. Published Dec 15, 2016.
Circulation Research. The epidemiology of blood pressure and its worldwide management. Published: Mar 13, 2015
Journal of Hypertension.  Obesity the most influencing and modifiable risk factors in Latin America. Published Sept 2016
Journal of the American Society of Hypertension. Worldwide prevalence of hypertension exceeds 1.3 billion. Published: Oct 2016.
World Health Organization. A global brief on HYPERTENSION. Silent killer, global public health crisis. Published: 2013
World’s Healthiest Foods. Potassium.

Susan Burke March, MEd, RDN, CDE, a Cuenca expat, is a Registered Dietitian, and  Certified Diabetes Educator who specializes in smart solutions for weight loss and diabetes-related weight management. She is the author of Making Weight Control Second Nature: Living Thin Naturally—a fun and informative book intended to liberate serial dieters and make healthy living and weight control both possible and instinctual over the long term. Do you have a food, nutrition or health question? Write to her at


Susan Burke March

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