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High Blood Pressure and Hypertensive Crisis

Hypertensive crisis is an umbrella term for hypertensive urgency and hypertensive emergency. These two conditions occur when blood pressure becomes very high, possibly causing organ damage.

Hypertensive Urgency

Hypertensive urgency occurs when blood pressure spikes -- blood pressure readings are 180/110 or higher -- but there is no damage to the body's organs. Blood pressure can be brought down safely within a few hours with blood pressure medication

 

 

Hypertensive Emergency

Hypertensive emergency means blood pressure is so high that organ damage can occur. Blood pressure must be reduced immediately to prevent imminent organ damage. This is done in an intensive care unit of a hospital.

Organ damage associated with hypertensive emergency may include:

  • Changes in mental status, such as confusion
  • Bleeding into the brain (stroke)
  • Heart failure
  • Chest pain (unstable angina)
  • Fluid in the lungs (pulmonary edema)
  • Heart attack
  • Aneurysm (aortic dissection )
  • Eclampsia (occurs during pregnancy)

Hypertensive emergency is rare. When it does occur, it is often when hypertension goes untreated, if the patient does not take his or her blood pressure medication, or he or she has taken an over-the-counter medication that exacerbates high blood pressure.

Symptoms of Hypertensive Emergency

Symptoms of a hypertensive emergency include:

  • Headache or blurred vision
  • Increasing confusion or level of consciousness
  • Seizure
  • Increasing chest pain
  • Increasing shortness of breath
  • Swelling or edema (fluid buildup in the tissues)

 

Diagnosing Hypertensive Emergency

To diagnose a hypertensive emergency, your health care providers will ask you several questions to get a better understanding of your medical history. They will also need to know all medications you are taking, including nonprescription and recreational drugs. Also, be sure to tell them if you are taking any herbal or dietary supplements.

Certain tests will be performed to monitor blood pressure and assess organ damage, including:

  • Regular monitoring of blood pressure
  • Eye exam to look for swelling and bleeding
  • Blood and urine testing

 

What's the Treatment for Hypertensive Emergency and Associated Organ Damage?

In a hypertensive emergency, the first goal is to bring down the blood pressure as quickly as possible with intravenous (IV) blood pressure medications to prevent further organ damage. Whatever organ damage that has occurred is treated with therapies specific to the organ that is damaged.

 

WebMD Medical Reference

Reviewed by James Beckerman, MD, FACC on October 31, 2013
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