What’s a hypertensive crisis? If I notice a spike in my blood pressure, what should I do?

Answer From Francisco Lopez-Jimenez, M.D.

A hypertensive crisis is a sudden, severe increase in blood pressure. The blood pressure reading is 180/120 millimeters of mercury (mm Hg) or greater. A hypertensive crisis is a medical emergency. It can lead to a heart attack, stroke or other life-threatening health problems.

Severely high blood pressure can damage blood vessels and body organs, including the heart, brain, kidneys and eyes. During a hypertensive crisis, the heart may not be able to pump blood effectively.

Hypertensive crises are grouped into two categories.

  • Urgent hypertensive crisis. Blood pressure is 180/120 mm Hg or greater. There are no signs of organ damage.
  • Emergency hypertensive crisis. Blood pressure is 180/120 mm Hg or greater. There is life-threatening damage to the body’s organs.

Causes of a hypertensive crisis include:

  • Forgetting to take blood pressure medication
  • Suddenly stopping certain heart medications, such as beta blockers
  • Medication interactions
  • Tumor of the adrenal gland (pheochromocytoma)

Symptoms of a hypertensive crisis may include:

  • Anxiety
  • Blurred vision
  • Chest pain
  • Confusion
  • Nausea and vomiting
  • Not responding to stimulation (unresponsiveness)
  • Seizures
  • Severe headache
  • Shortness of breath

If you get a very high blood pressure reading at home and don’t have any symptoms, relax for a few minutes. Then check your blood pressure again. If it’s still very high, seek medical care.

Call 911 or emergency medical services if your blood pressure is 180/120 mm Hg or greater and you have chest pain, shortness of breath, or symptoms of stroke. Stroke symptoms include numbness or tingling, trouble speaking, or changes in vision.

Treatment for a hypertensive crisis may include a hospital stay to monitor for organ damage. Medications to lower blood pressure are given by mouth or IV.

With

Francisco Lopez-Jimenez, M.D.

 

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