blood pressure is 180/120 or higher and you have blurred vision, increasing confusion, seizures, increasing chest pain, increasing shortness of breath, or edema (fluid build up).
While you wait:
If you live with hypertension, you’ll hopefully find ways to manage it daily and perhaps be taking prescribed medication. You’re probably monitoring your blood pressure regularly, perhaps using a home blood pressure monitor, and you may understand your condition well enough to know which triggers cause your blood pressure to rise.
That’s the ideal scenario. But what happens if, for whatever reason, your blood pressure increases to dangerous levels very quickly? That’s what’s known as a hypertensive crisis, and it’s a good idea to be aware of what this can look like and what to do if it happens to you.
Hypertensive crisis is defined as a blood pressure reading of 180/120 or higher:
|Blood pressure category||Systolic mmHg||Diastolic mmHg|
|Normal||less than 120||and||less than 80|
|Elevated||120-129||and||less than 80|
|High blood pressure (Hypertension stage 1)||130-139||or||80-89|
|High blood pressure (Hypertension stage 2)||140 or higher||or||90 or higher|
|Hypertensive crisis||180 or higher||and / or||120 or higher|
Source: American Heart Association
There are two types of hypertensive crises – hypertensive urgency and hypertensive emergency. Both require immediate medical attention.
Very high blood pressure can damage the blood vessels, meaning the heart cannot pump blood effectively. As a result, organs can be damaged. In a hypertensive emergency, there are signs that damage may already be taking place.
If your blood pressure is 180/120 or higher but you’re not experiencing any other symptoms – such as blurred vision, increasing confusion, seizures, increasing chest pain, increasing shortness of breath, or edema (fluid buildup) – this is considered hypertensive urgency. It may mean adjusting or adding to medications, but will rarely lead to a hospital stay.
If your blood pressure reading is 180/120 or higher and you have blurred vision, confusion, seizures, chest pain, shortness of breath, or edema (fluid buildup), this is considered a hypertensive emergency and you should call 999.
The usual cause of a sudden increase in blood pressure is failing to take prescribed blood pressure medication. Other causes of extremely high blood pressure include:
If you or someone you’re with has a blood pressure reading of 180/120 or higher and experiences any of the symptoms associated with hypertensive emergency – blurred vision, increasing confusion, seizures, increasing chest pain, increasing shortness of breath, or edema (fluid build up) – call 999 straight away and describe the symptoms and any medication that’s currently being taken.
While waiting for help, you need to try to lower blood pressure quickly. Lie down flat and try to stay calm. Closing your eyes and focusing on your breathing can help – inhale slowly, count to four, then do the same as you exhale.
During this time, you should also avoid drinks containing caffeine, as these can increase blood pressure in the short term.
Your doctor or healthcare provider will ask you about the medications you’re taking, including non-prescription and recreational drugs and herbal or dietary supplements, then bring your blood pressure down quickly with intravenous medications to prevent further damage.
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 and can also advise on lifestyle changes that can help you avoid future spikes in blood pressure.
Remember 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.