Cardiologist Dr Francesco Lo Monaco has identified five symptoms of high blood pressure that people should never ignore, even if they do not realise they have the condition. He also highlighted everyday habits that may quietly weaken the heart.
Five warning signs
The symptoms include breathlessness, swollen ankles, chest pain, palpitations, and unexplained fatigue. Dr Lo Monaco said anyone experiencing these should seek medical assessment as soon as possible.
“The encouraging news is that many of these risk factors are modifiable,” he said. “Keeping your blood pressure under control, treating sleep apnoea, maintaining a healthy weight, exercising regularly and limiting alcohol can all reduce the strain placed on the heart over time.”
Silent condition
High blood pressure is often described as a “silent killer” because many people have no symptoms until damage has already occurred. The NHS estimates that around 4.1 million people in England are living with it without realising.
Dr Lo Monaco explained: “When blood pressure remains elevated for months or years, the heart has to pump against greater resistance. Initially the heart muscle adapts by becoming thicker, but over time these changes can affect how efficiently the heart works. If left untreated, this can contribute to enlargement and weakening of the heart and eventually increase the risk of heart failure, abnormal heart rhythms and other cardiovascular complications.”
Everyday habits that strain the heart
Dr Lo Monaco listed five common lifestyle factors that put extra strain on the heart: poorly controlled blood pressure, untreated sleep apnoea, excess alcohol, obesity, and physical inactivity.
“The single biggest modifiable risk factor we see is high blood pressure,” he said. “Many people feel perfectly well, so they don’t realise the damage can be happening silently.”
On sleep apnoea, he said: “Sleep apnoea doesn’t just cause tiredness. It is strongly associated with high blood pressure, abnormal heart rhythms and structural changes within the heart.”
He noted that alcohol-related heart disease often develops gradually, and that carrying excess weight forces the heart to work harder continuously. A sedentary lifestyle contributes to obesity and high blood pressure, which are major risk factors.
