High Blood Pressure and Hypertensive Crisis

Medically Reviewed by Sabrina Felson, MD on September 08, 2023
2 min read

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



Hypertensive emergency means blood pressure is so high that organ damage can occur. Blood pressure must be reduced immediately to prevent imminent organ damage. 

Organ damage associated with hypertensive emergency may include:

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

Symptoms of a hypertensive emergency include:

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


To diagnose a hypertensive emergency, your health care providers will ask you several questions to get a better understanding of your medical history, such as whether you're taking blood pressure medication or have recently eaten something salty. 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


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 has occurred is treated with therapies specific to the organ that is damaged.