When High Blood Pressure Becomes an Emergency: A Guide for Patients

What is a High Blood Pressure Emergency?

Hypertensive Emergency

A high blood pressure emergency is a serious condition that occurs when blood pressure becomes dangerously high, leading to potential damage in one or more organs. If it is not treated immediately, it can lead to life-threatening complications. The following organs could be affected:

• Eyes: May cause bleeding at the back of the eye or swelling of the nerve which connects the eye to the brain.
• Brain: Swelling or bleeding in the brain, and even a stroke (brain damage due to lack of blood flow).
• Kidneys: Damage to the kidneys which may stop functioning properly.
• Heart: It can lead to heart attacks, heart failure, or damage to major blood vessels.

When is a High Blood Pressure an Emergency?

Blood pressure is expressed using two numbers. If someone says your blood pressure is "140 over 90," it means the pressure when your heart beats (systolic) is 140, and the pressure when your heart rests between beats (diastolic) is 90.

A blood pressure reading of 180/120 or higher is considered an Emergency, and it requires immediate medical attention.

Symptoms of a High Blood Pressure Emergency

Symptoms of hypertensive
Emergencies

The symptoms can vary depending on the organ  affected. Some common symptoms include:

• Blurry vision or changes in vision
• Severe headache
• Nausea or vomiting
• Confusion or difficulty thinking clearly
• Passing out or having seizures
• Weakness or numbness in one side of the body, or in one arm or leg
• Difficulty speaking
• Trouble breathing
• Chest pain
• Pain in the upper back or between the shoulders
• Blood in urine or brown-colored urine
• Pain in the lower back or side of the body

Will I Need Tests?

Yes. The doctor will conduct several tests to assess the severity of the situation. These might include:

• Blood tests
• Urine tests
• Chest X-ray
• Brain imaging (CT scan or MRI)
• Electrocardiogram (ECG) to measure heart activity

How is a High Blood Pressure Emergency Treated?

Treatment typically takes place in the hospital. Your doctor will use medications, often administered in a vein, to lower your blood pressure quickly. They may also address any damage to organs caused by the high blood pressure.

Following the emergency treatment, long-term management of blood pressure is important and may involve:

• Taking prescribed medications regularly
• Eating a balanced diet low in sodium, and rich in fruits and vegetables
• Losing weight if necessary
• Regular physical activity

When Should I Call the Doctor?

Seek medical help immediately if you experience any of the symptoms mentioned above. If you're monitoring your blood pressure at home, call your doctor if you get two or more readings of 180/120 or higher, even if you don’t have any symptoms.