Emergency Treatment for High Blood Pressure at Home

High Blood Pressure vs. Hypertensive Emergency

High blood pressure is common, and under a doctor’s supervision you can manage it with regular monitoring, healthy habits, and sometimes with prescription medications. If you have high blood pressure, chances are you’re familiar with using a home blood pressure monitor, and you may understand your condition well enough to know how to keep levels in check.

But what happens if blood pressure suddenly rises to dangerous levels? In that event you need to get immediate medical attention. That situation is known as a hypertensive crisis.

A hypertensive crisis

A hypertensive crisis is defined as a blood pressure reading of 180/120 or higher that requires immediate medical attention.

A normal blood pressure reading is less than 120 systolic and less than 80 diastolic. A medical doctor can help you manage elevated to high blood pressure, and a hypertensive crisis requires swift action.

Appropriate blood pressure levels are outlined below by the American Heart Association:

There are two types of hypertensive crises – hypertensive urgency and hypertensive emergency. Both require immediate medical attention.

Hypertensive urgency

If your blood pressure is 180/120 or higher but you’re not experiencing any other symptoms, such as blurred vision, increasing confusion, seizures, chest pain, shortness of breath, blood in urine, or edema (swelling), this is known as a hypertensive urgency. Your doctor may adjust or add to your medications, but you can usually avoid staying in hospital.

Hypertensive emergency

If your blood pressure reading is 180/120 or higher and you have other symptoms like blurred vision, confusion, seizures, chest pain, shortness of breath, blood in urine, or edema (swelling), this is considered a hypertensive emergency and you should call 911 immediately.

Very high blood pressure can damage the blood vessels, meaning the heart will not be able to pump blood effectively, while you can also suffer organ damage, cause a stroke, or suffer bleeding in the brain or body. In a hypertensive emergency, symptoms indicate that damage may already be taking place.

What can cause a sudden increase in blood pressure?

Typically, a sudden increase in blood pressure happens when a patient fails to take prescribed blood pressure medication. Other causes of extremely high blood pressure include:

• Untreated high blood pressure
• Certain over-the-counter medicines
• Intense stress or anxiety
• Cigarette smoking
• Alcohol abuse
• Amphetamine use
• Thyroid disease
• Kidney failure
• Heart disease
• Stroke
• Trauma, such as burns, head injuries or surgery
• Certain diseases and conditions, such as kidney disease or diabetes

At-risk groups

Some groups are more prone to a hypertensive crisis, as it’s more common if you’re older, male, black, and/or obese.

Around 1-2% of people with high blood pressure have a hypertensive crisis. But before blood pressure medicines were so common it was as high as 7%, highlighting the importance of keeping up with medications.

What to Do in a Hypertensive Emergency

If you or someone you’re with has a blood pressure reading of 180/120 or higher, call your doctor immediately.

If any of the symptoms associated with a hypertensive emergency accompany the high blood pressure reading – blurred vision, increasing confusion, seizures, chest pain, shortness of breath, or swelling – call 911 straight away and describe the symptoms.

Be sure to mention any medications you currently take, including vitamins, supplements, over-the-counter medicines, or recreational drugs.

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What to Do While You’re Waiting for Medical Attention

While waiting for help, it’s essential to take steps toward lowering blood pressure quickly. Here are a few tips that can help.

Avoid things that could raise blood pressure

Hypertensive emergencies are often triggered by anxiety, so taking steps to manage yourself mentally can make a big difference.

• Worrying about your medical event could make things worse. Instead, visualize yourself in a serene place while doing your breathing exercises
• Avoid drinks containing caffeine, as these can increase blood pressure in the short term
• Avoid sodium. No amount of salt is safe during a hypertensive crisis
• If anyone with you is panicking or stressed, ask them to take a step outside to collect themselves
• You can calm yourself with a book or television, but make sure what you’re watching is lighthearted, relaxing, and unlikely to excite you, whether in a positive or negative way
• Avoid cold beverages, as these can constrict blood vessels and make your blood pressure rise as a result
• If you are taking medications that tend to raise heart rate or blood pressure, such as amphetamines, ask your doctor if you can skip doses until your blood pressure is under control

Tricks to lower blood pressure instantly

While there’s no universal way to lower blood pressure on command, there are techniques that could be effective for some people. Everyone is individual and there are a lot of factors in play, but it doesn’t hurt to try.

Resume blood pressure medication, if prescribed

If you’ve forgotten or skipped one or more doses of your blood pressure medication, resume taking it, as advised by your doctor. Your condition may resolve with this step alone. If you’re unsure if you missed a dose, call your doctor and ask them how you should proceed.

Box breathing

A technique called box breathing is a good way of relaxing when feeling stressed. It should slow your heart rate and therefore bring blood pressure down.

Here’s how to do it:

• Sit in a comfortable chair with your feet on the floor
• Close your eyes and breathe through your nose, counting to four and feeling the air enter your lungs
• Hold your breath while counting slowly to four, making sure you don’t clamp your mouth or nose shut
• Slowly breathe out for four seconds
• Wait four seconds
• Then repeat the first three steps at least three times

Relaxation audio and other exercises

Relaxing audio can decrease your blood pressure and heart rate, while meditation tracks can have a similar effect.

There’s also biofeedback techniques, which you can practice with the help of an audio track. One such example is hand warming, a relaxation technique where you consciously raise the temperature of your hands.

Herbal remedies for high blood pressure

Herbal remedies may be a helpful approach to blood pressure concerns, although most take several weeks to take effect. Herbs that can lower blood pressure include basil, parsley, celery seeds, Chinese cat’s claw, Bacopa monnieri, garlic, thyme, cinnamon, ginger, and cardamom. Read more on the spices and herbs here.

Warm bath

A warm, relaxing bath may help calm your nerves and relax your muscles, which could help to lower blood pressure. However don’t do so if you are alone, as you could lose consciousness in a hypertensive crisis.

High nitric oxide vegetables

Certain vegetables are high in nitric oxide which could help the blood vessels relax. This may potentially reduce force against veins, arteries, and capillaries. Dietary modifications could take weeks to have an effect.

If you have spinach, beets, rhubarb, or carrots on hand, you may want to have them as a small snack or blend a quick smoothie and see if it helps. Check to make sure your other smoothie ingredients do not contain sodium. Do not prepare food yourself if you’re in the middle of a hypertensive emergency. In that situation you’re better off lying comfortably until help arrives.

Read more about vegetables that may help maintain a healthy blood pressure.

Keep yourself warm

If you feel cold, your blood vessels may constrict which could raise your blood pressure even higher. Keep yourself warm to avoid any unnecessary blood pressure changes.

What to do: hypertensive urgency

If you or someone you’re with has a blood pressure reading of 180/120 or higher, but has no other symptoms, wait around five minutes and take the reading again. If it’s still high, seek medical advice urgently and try to stay calm. You should also be ready to share details of your medications and a log of blood pressure readings if you have one.

Your doctor may adjust your dose or add medications, as well as advising on lifestyle changes that can help you avoid future spikes in blood pressure. Chances are, your doctor can work with you over the phone to help resolve your blood pressure crisis.

Preventing a hypertensive crisis

To ensure you don’t have a blood pressure spike, make sure you keep taking medicines you’re prescribed, even if you feel fine. It can take a prolonged period for your blood pressure levels to return to normal.

If you’re at risk, you can take steps to improve your blood pressure, making it less likely you’ll suffer a hypertensive urgency or emergency. Steps you can take include cutting salt from your diet, exercising regularly, and stopping smoking.

You should also ensure you check your blood pressure regularly, firstly to monitor your progress as you improve your lifestyle, and secondly to respond if your blood pressure goes above the 180/120 mark.

Final thoughts

Remember a hypertensive emergency is rare, and when it does occur it’s usually caused by failing to take prescribed blood pressure medication.

If you’ve been diagnosed with high blood pressure, the best way to safeguard your health is through a healthy lifestyle, a balanced diet and prescribed medication. Another way you can take control of your health is by tracking your blood pressure and medication. In an emergency, having that information to hand could make all the difference.

Disclaimer: The information provided in this article is for general information purposes only and is not intended to be a substitute for professional medical advice. Always consult your physician or qualified healthcare provider for any questions related to a medical condition. The author and publisher are not liable for any harm or damage resulting from the use or misuse of the information in this article.

Sources

American Heart Association, Understanding Blood Pressure Readings, May 17, 2024 – https://www.heart.org/health-topics-high-blood-pressure-understanding-blood-pressure-readings

Government of British Columbia, Blood pressure categories – https://www2.gov.bc.ca/health-practitioner-professional-resources-bc-guidelines-hypertension

Health Link BC, Hypertensive Emergency, September 7, 2022 – https://www.healthlinkbc.ca/illnesses-conditions-heart-health-and-stroke-hypertensive-emergency

Merck Manual, Hypertensive Emergencies, September 2023 – https://www.merckmanuals.com/cardiovascular-disorders-hypertension-hypertensive-emergencies

Medical News Today, What is box breathing?  May 13, 2024 – https://www.medicalnewstoday.com/articles-breathing-and-health

My Health Alberta, Relaxation for stress, chronic pain, and headache relief, March 18, 2022 – https://myhealth.alberta.ca/alberta-relaxation-audio-tracks

Healthline, 10 Spices And Herbs That May Help Lower High Blood Pressure, September 3, 2024 – https://www.healthline.com/nutrition-herbs-to-lower-blood-pressure

Cleveland Clinic, Hypertensive Crisis, November 22, 2022 – https://my.clevelandclinic.org/health-diseases-hypertensive-crisis