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Hypertensive Crisis: How Does it Happen?

Hypertensive Crisis: How Does it Happen?

Hypertensive crisis is a combination of hypertensive urgency and hypertensive emergency. This means that when the blood pressure of a patient spikes to more than average, he or she can go into a state of either of the above-mentioned conditions. It can sometimes also lead to organ damage if not attended well in time.

Blood pressure is measured in mm Hg, short for millimeters of mercury. 120/80 mm Hg is considered normal BP for a healthy body. The top value, i.e 120, is known as systolic blood pressure.

When your heart beats, this is the highest level your blood pressure should reach. While the lower level, which is 80, is known as diastolic blood pressure.

When your heart relaxes in between two beats, this is the lowest level of blood pressure it should ideally achieve.

Blood pressure is determined by how much blood is pumped in the body and the resistant force of this blood in the arteries. Hypertension would mean that this force of blood against your arteries will eventually lead to issues like cardiovascular diseases.

According to the American Heart Association, in a hypertensive crisis, your blood can rise up to 180/120 mm Hg. This article will talk about how to know if you have hypertensive urgency or hypertensive emergency, what symptoms to look out for, how to take care when in a hypertensive crisis, and when to contact the doctor immediately.

What Are the Types of Hypertension?

What is hypertensive urgency?

Hypertensive urgency is when your blood pressure rises up to 180/120 mm Hg, but no signs of organ damage are visible. These signs are heavy breathing, chest pain, shortness of breath, blurred vision, back pain, severe headache, or slurred speech. Hypertensive urgency doesn’t require hospitalisation or rushing to the emergency room.

This condition can be taken care of with the help of medications and healthy habits over a period of time. If your blood pressure reading reaches 180/120 mm Hg, take another reading after five minutes. If it lowers a bit, then you might be having hypertensive urgency.

Consult your doctor before popping a pill or consuming any high-sodium foods.

hypertensive crisis

What is a hypertensive emergency?

Hypertensive emergency is the most dangerous situation that requires immediate attention or can be fatal. It is a rare condition and can happen if the patient has been irregular with their hypertension medication or was not aware of his/her blood pressure issues in the first place.

Hypertensive emergency means that the blood pressure has reached the 180/120 mmHg mark, and remains constant even after checking twice or thrice. This BP range is so high that it can possibly lead to organ damage.

It indicates either of the following damages:

  1. Brain stroke
  2. Mental problems like confusion or not being able to comprehend the surroundings
  3. Heart failure
  4. Heart attack
  5. Persistent chest pain
  6. Aneurysm
  7. Pulmonary edema
  8. Eclampsia– a condition that occurs due to high blood pressure during pregnancy, which results in seizures

Having consistent hypertensive urgency that lasts a few hours combined with the symptoms of targeted organ damage can potentially lead to a hypertensive emergency.

If you are already a hypertension patient and also taking other medications, consult your doctor about how the combination of these pills might affect your blood pressure. Or if you are going to different doctors, let them know about your hypertension.

What are the symptoms of a hypertensive crisis?

Though the symptoms of hypertensive urgency subside eventually in a few hours after taking the required medication, the following are the symptoms that you should look out for.

Remember to check your blood pressure twice or thrice to make sure it isn’t a hypertensive emergency.

  1. Sweating
  2. Severe headache
  3. Chest pain
  4. Difficulty in breathing
  5. Blurry vision
  6. Confusion
  7. Fatigue or tiredness

What are the symptoms of a hypertensive crisis?

As mentioned above, continuous symptoms of hypertensive urgency result in a hypertensive emergency. If your blood pressure remains 180/120 mm Hg consistently, even after checking two to three times, getting immediate medical attention is required.

Bringing this blood pressure down with tablets may be difficult and other means may have to be used. Consult your doctor right away if you’re experiencing any or some of the following symptoms related to a hypertensive emergency:

  1. Shortness of breath
  2. Severe headache which makes your vision blurry
  3. Confusion
  4. Increasing and repeated chest pains
  5. Seizures
  6. Nose bleeding
  7. Unresponsiveness
  8. Nausea or vomiting
  9. Slurred speech

Remember that the above-mentioned symptoms may not subside even by taking blood pressure medicine and often need to be treated with intravenous medicines.

Hypertensive crisis treatment

For hypertensive urgency: In all possible cases, your doctor will either add a medication to your list or adjust the dosage of the existing ones. If this is your first experience with high blood pressure, it is a sign for you to be regular with your medication. In extremely rare instances will hypertensive urgency require hospitalisation. Therefore, carefully monitoring your blood pressure for uniformity will help.

For hypertensive emergency: Since this indicates probable organ damage, the treatment for a hypertensive emergency is more intense. It would require immediate hospitalisation with regular blood pressure monitoring, blood and urine tests as well as eye examinations to look for swelling or bleeding due to high blood pressure.

An intravenous (IV) will be used to lower and bring the blood pressure down to a healthy parameter. However, recovery is tricky and would need thorough diligence with medication, eating habits, psychological balance, and exercise thereafter.

When should you seek immediate medical attention?

Some classic signs of hypertensive crisis include difficulty in breathing or shortness of breath or hyperventilation, excessive and non-stop sweating, severe and pounding headache, increasing chest pains, blurry vision, slurred speech, and confusion or bewilderment.

If you notice the above-mentioned indications, check your blood pressure right away. A healthy blood pressure range is 120/80 mm Hg. If you see it rising or moving towards the higher side, speak to your doctor. Do not wait for it to reach a potential 180/120 mm Hg, which can be fatal if not treated in time.

Staying regular with your medications, practising healthy eating habits, exercising only till your body can take it, and meditating to keep anxiousness at bay are some factors, which can help prevent a hypertensive crisis. Do not take or combine any two medicines on your own, consult your doctor about the best way forward.

Learn more about hypertension here.


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Written by Nikita Bhalla Updated Apr 05, 2021
Fact Checked by Hello Doctor Medical Panel