6 Surprising Complications of High Blood Pressure

The good news: Once you know you have high blood pressure, you can take steps to control it, which can then halt or even reverse many of these surprising complications.

1. Unexpected Memory Troubles and Vascular Dementia

“Chronic hypertension physically changes the structure of the brain’s microscopic blood vessels, starving brain cells of the oxygen and nutrients they need to function,” explains Yaz Daaboul, MD, a cardiologist who leads the advanced cardiac imaging program at Harrison Memorial Hospital in Cynthiana, Kentucky. “These microscopic vessels narrow, clog, or burst, causing hundreds of ‘silent mini-strokes’ over several years.” Eventually, this can result in a specific version of dementia, called vascular dementia, he says.

“Controlling blood pressure is absolutely vital to maintaining brain health later in life,” says Srihari Naidu, MD, a professor of medicine at New York Medical College in Valhalla, New York.

2. Eye Damage and Vision Loss

“Uncontrolled hypertension can affect the blood vessels involving the retina [the back lining of the inner part of your eye], which can lead to vision loss,” says Jay R. Silverstein, MD, a cardiologist at LCMC Health Lakeview Hospital in Covington, Louisiana. “It happens slowly over time and isn’t noticed unless a physician examines the retina.”

• Hypertensive retinopathy, which occurs when blood vessel damage prevents blood from flowing to the eyes, resulting in blurred vision or vision loss.
• Choroidopathy, in which fluid builds up around the retina, distorting vision.
• Optic neuropathy, in which blocked blood flow affects the optic nerve, killing nerve cells in the eyes, leading to vision loss.

3. Sexual Dysfunction

4. Kidney Damage

“Uncontrolled hypertension damages the kidney slowly over time,” Dr. Silverstein says. “It isn’t typically felt or detected by a patient and is only discovered on blood work showing changes in kidney function or losing protein in the urine.”

5. Bone Loss (Osteoporosis)

“When blood pressure is chronically high, it disrupts how the kidneys process minerals,” Daaboul says. “Instead of keeping calcium in the bloodstream, the body flushes it out through urine, forcing the skeletal system to deplete its own calcium stores to compensate.”

6. Sleep Apnea and Sleep Disturbances

High blood pressure can raise the risk of a condition called obstructive sleep apnea, in which a person stops breathing temporarily during sleep. Sometimes, though, this is a secondary effect — high blood pressure can raise the risk of obesity and heart failure, which can then lead to sleep apnea, says Dr. Naidu.

Ways to Lower Your Blood Pressure

You have more control over your blood pressure than you might think. “Hypertension is a modifiable risk factor,” says Daaboul.

• Follow a healthy diet. Eating plans like the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet, which focus on fruits, vegetables, whole grains, and low-fat dairy while limiting saturated fats and sodium, can help reduce blood pressure.
• Stay active. Regular aerobic activity is a good way to improve heart health, relax blood vessels, and improve blood flow, all of which helps lower blood pressure. Aim for 150 minutes of moderate intensity or 75 minutes of high intensity physical activity per week.
• Maintain a healthy weight. Carrying extra weight is a major risk factor for hypertension. Losing even a small amount of weight can lead to a decrease in blood pressure in people who are overweight or have obesity.
• Don’t smoke. Tobacco and nicotine raise blood pressure, so quitting cigarettes, e-cigarettes, and vapes (or never starting) is an important part of heart health.
• Limit alcohol. Alcohol can affect blood pressure and how well hypertension medications work. If you choose to consume alcohol, limit yourself to one drink per day.

Remember: You don’t have to make all these changes at once. “Start with one, make it a habit, then add another if you can,” says Dr. Rhee. “The best lifestyle change is the one that you can sustain.”