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:
- Blurred vision
- Chest pain
- Nausea and vomiting
- Not responding to stimulation (unresponsiveness)
- 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.
Francisco Lopez-Jimenez, M.D.
There is a problem with
information submitted for this request. Review/update the
information highlighted below and resubmit the form.
From Mayo Clinic to your inbox
Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.
To provide you with the most relevant and helpful information, and understand which
information is beneficial, we may combine your email and website usage information with
other information we have about you. If you are a Mayo Clinic patient, this could
include protected health information. If we combine this information with your protected
health information, we will treat all of that information as protected health
information and will only use or disclose that information as set forth in our notice of
privacy practices. You may opt-out of email communications at any time by clicking on
the unsubscribe link in the e-mail.
Thank you for subscribing
Our Housecall e-newsletter will keep you up-to-date on the latest health information.
Sorry something went wrong with your subscription
Please, try again in a couple of minutes
Aug. 03, 2022
- Hypertensive crisis: When you should call 911 for high blood pressure. American Heart Association. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/hypertensive-crisis-when-you-should-call-911-for-high-blood-pressure. Accessed June 13, 2022.
- Ferri FF. Hypertension. In: Ferri’s Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed July 15, 2022.
- Elliott WJ. Evaluation and treatment of hypertensive emergencies in adults. https://www.uptodate.com/contents/search. Accessed June 14, 2022.
- Varon J, et al. Management of severe asymptomatic hypertension (hypertensive urgencies) in adults. https://www.uptodate.com/contents/search. Accessed June 14, 2022.
- Whelton PK, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018; doi:10.1161/HYP.0000000000000065.
- Lopez-Jimenez F (expert opinion). Mayo Clinic. July 6, 2022.
- Benenson I, et al. Risk factors for hypertensive crisis in adult patients: A systematic review. JBI Evidence Synthesis. 2021; doi:10.11124/JBIES-20-00243.