Hypertensive crisis (dangerously high blood pressure)

Overview

Blood pressure over 180/120 is a crisis.

It can harm the brain, heart, and kidneys.

Symptoms

Common signs:

• Blood pressure 180/120 with chest pain or headache
• Confusion or vision changes
• Shortness of breath
• High blood pressure reading

Less common

• Nosebleed

Look up a symptom: Blurry vision · Headache · Racing or pounding heartbeat

When to get medical care

Causes

Uncontrolled blood pressure.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Missed medicines

Diagnosis

This is diagnosed in the emergency room or hospital.

The exam

A physical exam.

Tests

Tests, if needed:

• Exam:

Treatment

Emergency care is needed. While waiting for help:

Self-care

• Recheck after 5 minutes
• Call 911 if symptoms
• Take blood pressure medicines daily

Prevention

To lower your risk or prevent problems:

• Don't stop blood pressure medicine suddenly

Which doctor treats this

• Emergency doctors treat it first, in the ER.
• They may send you to a cardiologist (heart doctor) if it's hard to control.

Living with it

• Check your blood pressure at home and write it down.
• Eat less salt and more fruits and vegetables.
• Take your medicine every day, even when you feel fine.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

• American Heart Association: Plain-language heart information and a support network for patients.

Back to school, work, or sports

• Recovery time varies. Ask your care team when you can drive, lift, work, and exercise.

Children, pregnancy, and older adults

• People with untreated high blood pressure: Highest risk.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• This condition needs closer checkups during pregnancy. Plan ahead with your doctor.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Learn CPR. Many hospitals and the Red Cross offer classes.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Outlook depends on the cause; early care helps.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• A list of your medicines and supplements
• Notes on when symptoms started and what makes them better or worse

Questions to ask

• What follow-up care do I need?
• How can I prevent this from happening again?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Hypertensive crisis (dangerously high blood pressure)