Signs and Symptoms
<p >Hypertension is rarely accompanied by any symptoms, and its identification is usually through <a href="http://en.wikipedia.org/wiki/Screening(medicine)" title="Screening (medicine)" >screening</a>, or when seeking healthcare for an unrelated problem. A proportion of people with high blood pressure reports <a href="http://en.wikipedia.org/wiki/Headache" title="Headache" >headaches</a> (particularly at the <a href="http://en.wikipedia.org/wiki/Occiput" title="Occiput" >back of the head</a> and in the morning), as well as<a href="http://en.wikipedia.org/wiki/Lightheadedness" title="Lightheadedness" >lightheadedness</a>, <a href="http://en.wikipedia.org/wiki/Vertigo" title="Vertigo" >vertigo</a>, <a href="http://en.wikipedia.org/wiki/Tinnitus" title="Tinnitus" >tinnitus</a> (buzzing or hissing in the ears), altered vision or <a href="http://en.wikipedia.org/wiki/Syncope(medicine)" title="Syncope (medicine)" >fainting episodes</a>.<sup id="cite_ref-Fisher2005_8-0" class="reference" ><a href="http://en.wikipedia.org/wiki/Hypertension#cite_note-Fisher2005-8" >[9]</a></sup></p>
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On <a href="http://en.wikipedia.org/wiki/Physical_examination" title="Physical examination" >physical examination</a>, hypertension may be suspected on the basis of the presence of <a href="http://en.wikipedia.org/wiki/Hypertensive_retinopathy" title="Hypertensive retinopathy" >hypertensive retinopathy</a> detected by examination of the<a href="http://en.wikipedia.org/wiki/Optic_fundus" title="Optic fundus" class="mw-redirect" >optic fundus</a> found in the back of the eye using <a href="http://en.wikipedia.org/wiki/Ophthalmoscopy" title="Ophthalmoscopy" >ophthalmoscopy</a>.<sup id="cite_ref-Wong2007_9-0" class="reference" ><a href="http://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9" >[10]</a></sup> Classically, the severity of the hypertensive retinopathy changes is graded from grade I–IV, although the milder types may be difficult to distinguish from each other.<sup id="cite_ref-Wong2007_9-1" class="reference" ><a href="http://en.wikipedia.org/wiki/Hypertension#cite_note-Wong2007-9" >[10]</a></sup> Ophthalmoscopy findings may also indicate how long a person has been hypertensive.<sup id="cite_ref-Fisher2005_8-1" class="reference" ><a href="http://en.wikipedia.org/wiki/Hypertension#cite_note-Fisher2005-8" >[9]</a></sup></p>