Does High Blood Pressure Make You Tired, Cold or Unwell?

High blood pressure usually causes no symptoms at all, so it is not normally the direct cause of tiredness. Yet many people with high blood pressure do feel tired. The reasons usually lie in the conditions that tend to come with it, or in the medicines used to treat it, and most of them can be identified and improved.

This guide explains the link between high blood pressure and fatigue, the most common real causes, what to check and when tiredness needs prompt medical attention.

Quick answer

High blood pressure itself rarely makes you tired, cold or unwell. Fatigue is more often caused by blood pressure medicines, particularly beta blockers, which can also cause cold hands and feet, by undiagnosed sleep apnoea, or by conditions such as anaemia, an underactive thyroid, diabetes or kidney disease. Do not stop your tablets. Your GP or pharmacist can often find the cause.

Why high blood pressure rarely causes tiredness

Most people with high blood pressure feel completely well, which is why it is often called a silent condition. Raised pressure damages the blood vessels gradually over years without causing day-to-day symptoms. Only very high blood pressure, usually 180/120 or higher, causes symptoms, and those tend to be severe headaches, vision changes or confusion rather than ordinary tiredness.

Can high blood pressure make you feel unwell?

Usually not. Most people with high blood pressure feel completely normal, and the only way to know your blood pressure is to have it measured. If you feel unwell, the cause is more likely to be:

• Your medicines. Side effects are common in the first few weeks. Amlodipine can cause headaches, flushing and swollen ankles, ACE inhibitors such as ramipril can cause a dry cough and dizziness, and beta blockers can cause tiredness and cold hands
• Blood pressure dropping too low after starting or increasing a medicine, which can make you dizzy, light-headed or faint
• A linked condition, such as sleep apnoea, diabetes or kidney disease

Very high blood pressure, around 180/120 or higher, can sometimes cause a severe headache, blurred vision, chest pain or breathlessness, and needs urgent medical help. Call 999 if you have chest pain, breathlessness or signs of a stroke. For what pushes blood pressure up in the first place, see the causes of high blood pressure.

Feeling cold and tired: what can cause it?

Feeling cold and tired together has several common causes:

• Beta blockers, such as bisoprolol, atenolol and propranolol, often cause cold fingers and toes as well as tiredness, because they slow the heart and reduce blood flow to the hands and feet
• An underactive thyroid, which causes tiredness, sensitivity to cold, weight gain and low mood. See underactive thyroid symptoms
• Iron deficiency anaemia, which causes tiredness, pale skin and breathlessness
• Not eating or sleeping enough, as being underweight or short of sleep can leave you feeling chilly and drained
• A cold or other viral infection. Tiredness is normal with a common cold, which usually gets better within one to two weeks

If you feel cold and tired for more than a few weeks, see your GP, who can check your medicines and arrange blood tests such as thyroid function and a full blood count.

Feeling light-headed and tired with high blood pressure

Light-headedness, dizziness and tiredness together are most often a sign that blood pressure medicines are lowering your pressure too far, particularly when you stand up quickly. Water tablets can add to this by causing dehydration or low salt levels, especially in hot weather or if you are unwell with vomiting or diarrhoea. Check your blood pressure sitting and standing, drink enough fluids and stand up slowly, and tell your GP, as your dose may need adjusting. Never stop your medicine on your own. See why do I feel light-headed?

Common reasons people with high blood pressure feel tired

• Blood pressure medicines. Beta blockers, such as bisoprolol and atenolol, commonly cause tiredness and cold hands. Water tablets (diuretics) can lower potassium or sodium levels, which can cause tiredness and cramps. Any medicine that lowers blood pressure too far can leave you dizzy and drained. Side effects often ease after the first few weeks, and switching to a different medicine usually helps if they do not.
• Obstructive sleep apnoea. This is common in people with high blood pressure, and it also raises blood pressure. Loud snoring, pauses in breathing, waking unrefreshed and feeling sleepy during the day are typical signs. It is treatable.
• Excess weight and inactivity. Both raise blood pressure and lower energy, and regular activity improves both.
• Other conditions that often travel with high blood pressure, including anaemia, an underactive thyroid, type 2 diabetes, kidney disease and depression
• Heart problems. Over many years, uncontrolled high blood pressure can lead to heart failure, which causes tiredness together with breathlessness and swollen ankles.
• Poor sleep and stress, which affect both energy and blood pressure

What to do if you feel tired

• Keep taking your medicines and ask your GP or pharmacist whether they could be the cause, especially if the tiredness started after a new medicine or a dose change
• Check your blood pressure at home, including standing readings if you feel light-headed when you get up, to see whether it has dropped too low
• Ask about blood tests, such as a full blood count, kidney function and salts, thyroid function and HbA1c
• Mention snoring or pauses in breathing so your GP can consider sleep apnoea
• Build up activity gradually, as regular movement improves energy and lowers blood pressure
• Protect your sleep with regular sleep and wake times

For more on finding the cause, see which blood tests can help explain tiredness and why am I so tired all the time?

When to seek medical help

Call 999 if you have a very high reading with chest pain, a severe headache, breathlessness, confusion, changes in your vision, difficulty speaking, or weakness, numbness or drooping on one side of the face or body.

Get same-day medical advice, from your GP or NHS 111, if:

• You faint, or repeatedly feel faint when standing up
• You become breathless when lying flat or with little effort, or your ankles are newly swollen
• Your readings are below 90/60 and you feel unwell

See your GP if:

• Tiredness has lasted more than a few weeks
• It started after a new medicine or a dose change
• You snore loudly, stop breathing at night or fall asleep during the day

Frequently asked questions

Can blood pressure tablets make you tired?

Yes. Tiredness is a common side effect, particularly of beta blockers. It often eases after a few weeks, and your GP can usually switch you to a different medicine if it does not. Do not stop taking them without advice.

Does low blood pressure cause tiredness?

It can. If treatment lowers your blood pressure too far, you may feel tired, dizzy or light-headed, especially when standing up. Tell your GP, as your dose may need adjusting.

Can high blood pressure make you sleep a lot?

Not directly. Sleeping much more than usual, or feeling sleepy in the day, is more often linked with obstructive sleep apnoea, depression, an underactive thyroid or the side effects of medicines such as beta blockers. If you are sleeping a lot and still waking unrefreshed, tell your GP.

Can high blood pressure make you dizzy?

Not usually. Dizziness in people with high blood pressure is more often caused by medicines lowering it too far, or by an unrelated problem. Sudden dizziness with other stroke symptoms needs a 999 call.

Can high blood pressure cause headaches?

Usually not. Only very high blood pressure tends to cause headaches, and a sudden severe headache with a very high reading needs urgent medical help.

Blood pressure and energy support in Chiswick

Lifestyle support for blood pressure and low energy, including blood tests, is available at Omnia Lifestyle, 8 to 9 Bedford Corner, The Avenue, Chiswick W4 1LZ, close to Turnham Green station, on bus routes 94, E3 and 272. Limited parking is available on request when booking. We work alongside your GP's care and never change or advise stopping prescribed medicine.

If you want to look for a cause of tiredness, you can book a private blood test in Chiswick without a GP referral, such as a full blood count or thyroid test, or our Tired All The Time health check with 43 biomarkers. An Omnia practitioner goes through your results with you, and you get a written report to share with your GP.

Read more about high blood pressure and fatigue, see what counts as a high blood pressure reading and what causes high blood pressure, explore blood tests and fitness and nutrition coaching, or book an appointment.

This article is general information, not medical advice. If you have any of the warning signs listed above, seek medical attention.