Hypertensive crisis occurs when a person’s blood pressure surges to an unusually high level. This condition can cause damage to blood vessels and major organs.
This article looks at some causes of hypertensive crisis and some treatment options available.
It also outlines some lifestyle factors that may help lower a person’s blood pressure and reduce their risk of experiencing hypertensive crisis.
Healthcare providers assess blood pressure using a blood pressure monitor, or sphygmomanometer. This tool produces a reading based on two types of blood pressure: systolic and diastolic.
Systolic pressure refers to the pressure inside blood vessels as the heart forces blood out to the rest of the organs. Diastolic pressure refers to the pressure inside blood vessels as the heart rests between beats. Blood pressure is measured in millimeters of mercury (mm Hg).
A sphygmomanometer displays the systolic pressure reading above the diastolic pressure reading. If a person has a
Hypertension occurs when a person’s blood pressure exceeds normal values. There are two stages of hypertension: stage 1 and stage 2.
Stage 1 hypertension will produce a reading of 130–139 mm Hg over 80–89 mm Hg. Stage 2 hypertension, which is a more severe form, will produce a reading of 140 mm Hg or higher over 90 mm Hg or higher.
According to the Centers for Disease Control and Prevention (CDC), around
Uncontrolled hypertension can lead to a sudden and severe increase in blood pressure. This increase is known as hypertensive crisis.
A person who is experiencing
There are two types of hypertensive crisis: hypertensive urgency and hypertensive emergency.
Hypertensive urgency occurs when a person has the readings above but no associated symptoms. Hypertensive emergency occurs when a person has the readings above as well as the associated symptoms described below.
Hypertensive crisis can damage blood vessels and major organs. In 2018 alone, nearly
- having overweight or obesity
- eating an unhealthful diet that is high in salt
- not getting very much physical activity
- having a history of cardiovascular disease
- having an underlying health condition, such as diabetes or kidney disease
The following factors are commonly associated with hypertensive crisis:
- not taking, or forgetting to take, prescribed blood pressure medications
- taking medications that interact with each other in a way that increases blood pressure
- using illegal drugs, such as cocaine or amphetamines
- having a life threatening cardiovascular condition, such as a stroke or heart attack
- experiencing organ failure, such as heart or kidney failure
Some people experiencing hypertensive crisis may have symptoms, while others may not have any symptoms at all.
People who are able to check their own blood pressure may see a reading of 180 mm Hg/120 mm Hg or greater. If no other symptoms are present, the AHA recommend
If their blood pressure is high and the person is also experiencing one or more of the following symptoms, someone should call 911 immediately:
- severe headache or migraine
- severe anxiety
- nausea or vomiting
- chest pain
- changes in vision
- shortness of breath
- fits or seizures
A healthcare provider will take a number of blood pressure readings and ask the person about their symptoms and medical history. They will also ask about any medications or supplements the person is taking and whether or not they have used any recreational drugs.
If the healthcare provider suspects that there is a risk of organ damage due to hypertensive crisis, they will arrange for further tests. These may include:
- blood tests
- urine tests
- an eye examination
- an echocardiogram of the heart
- an ultrasound of the heart, kidneys, or both
- a chest X-ray of the heart and lungs
- a CT or MRI scan of the brain
The first-line treatment for hypertensive crisis will typically be intravenous antihypertensive medications to lower the person’s blood pressure. Healthcare providers usually aim to reduce blood pressure by no more than
Once a person’s blood pressure is under control, the healthcare provider will usually switch to using oral antihypertensive medications.
The medications a healthcare provider uses to lower blood pressure may differ according to several factors, including:
- whether or not the person is pregnant
- whether or not the person has an underlying health condition
- whether or not hypertensive crisis occurred due to the use of illegal drugs
The most important thing that a person with hypertension can do to prevent hypertensive crisis is to take their blood pressure medications exactly as prescribed.
Below are some lifestyle changes that people can make to help lower their blood pressure and reduce the risk of experiencing hypertensive crisis.
Eat a healthful diet
A healthful diet is one that is rich in fruits, vegetables, and fiber and low in fat and salt. Lowering salt intake can directly lower blood pressure.
Cut down on alcohol
Limiting alcohol intake to the recommended levels will help lower blood pressure and improve overall health.
Keep physically active
Getting regular exercise helps keep the heart and circulatory system healthy. It can also help people lose excess weight, which can also help lower high blood pressure.
The CDC recommend that people aim to do
Smoking raises a person’s blood pressure and increases the risk of experiencing cardiovascular issues, such as heart attack and stroke.
People who smoke may wish to talk with their healthcare provider for advice on how to quit.
Get enough sleep
Good sleep is important to overall health, but it is especially important for the heart and circulatory system. This is because blood pressure drops during sleep.
Adults should aim to get at least
- getting plenty of physical activity during the day
- waking up and going to sleep at the same time each day
- following a consistent bedtime routine
- ensuring that the sleeping environment is cool, dark, comfortable, and free from noise and other distractions
Hypertensive crisis occurs when blood pressure rises to an unusually high level of 180 mm Hg/120 mm Hg or higher.
A person experiencing hypertensive crisis may or may not experience any symptoms. However, without treatment, the condition can damage blood vessels and major organs.
Factors that can give rise to hypertensive crisis include not taking antihypertensive medications, interactions between certain medications, and the use of illegal drugs. Certain underlying health conditions can also trigger hypertensive crisis.
However, there are some steps a person can take to lower their blood pressure and reduce the risk of experiencing hypertensive crisis. These steps include following a healthful diet, reducing alcohol intake, and quitting smoking.
Anyone who would like further advice about lowering their blood pressure may wish to book an appointment with their healthcare provider.