Blood pressure is a measurement of the force blood exerts against the walls of your arteries as it circulates through your body. It is expressed as two numbers: systolic and diastolic. A reading of 184/94 millimeters of mercury (mmHg) indicates severe hypertension, a condition requiring urgent medical attention. This situation can be either a hypertensive urgency or a hypertensive emergency.
Understanding the Significance of 184/94
The first, or top, number is the systolic pressure, which measures the pressure in your arteries when your heart beats and pumps blood. The second, or bottom, number is the diastolic pressure, reflecting the pressure in your arteries when your heart rests between beats. Both numbers are important, but systolic pressure can be a stronger predictor of heart disease risk for individuals over 50.
This classification applies when the systolic pressure is higher than 180 mmHg and/or the diastolic pressure is higher than 120 mmHg. Within this crisis category, there are two distinct scenarios: hypertensive urgency and hypertensive emergency.
Hypertensive urgency describes a situation where blood pressure is severely elevated (typically 180/120 mmHg or higher) but without immediate signs of organ damage. Symptoms might include a severe headache, shortness of breath, or nosebleeds, though these do not signify direct harm to organs. In contrast, a hypertensive emergency involves blood pressure at similar dangerously high levels (180/120 mmHg or higher) accompanied by acute, life-threatening damage to vital organs such as the brain, heart, kidneys, or eyes.
The presence or absence of organ damage is the key factor distinguishing between urgency and emergency. While hypertensive urgency is not immediately life-threatening, it carries a high risk of progressing to an emergency if not addressed promptly. A hypertensive emergency, however, is a medical crisis demanding immediate hospitalization and intervention to prevent irreversible damage or even death.
Immediate Actions and Urgent Considerations
Given a blood pressure reading of 184/94 mmHg, seeking immediate medical attention is important. This level of hypertension requires prompt evaluation by a healthcare professional. Do not attempt to self-treat or wait for the pressure to decrease on its own.
Contacting emergency services like 911 or proceeding to the nearest emergency room is appropriate. If those options are not immediately available, contacting your doctor without delay for guidance is important. Rapid intervention can prevent complications associated with severely elevated blood pressure.
Certain symptoms, when present with a blood pressure reading of 180/120 mmHg or higher, indicate a hypertensive emergency and necessitate immediate medical care. These symptoms suggest the high blood pressure is affecting vital organs and requires urgent treatment to mitigate harm.
- Severe headache
- Chest pain or tightness
- Shortness of breath
- Vision changes like blurred vision or sudden vision loss
- Nausea and vomiting
- Numbness or weakness
- Confusion
- Difficulty speaking
- Dizziness
Underlying Causes and Contributing Factors
Elevated blood pressure can stem from various sources, broadly categorized into primary and secondary hypertension. Primary, or essential, hypertension is the most common form, developing gradually over many years without an identifiable single cause. This type is often influenced by a combination of genetic predispositions and lifestyle factors.
Lifestyle choices significantly contribute to primary hypertension. For individuals already diagnosed with hypertension and on medication, inconsistent adherence to prescribed treatments can lead to dangerous blood pressure spikes.
- A diet high in sodium
- Insufficient physical activity
- Excessive stress
- Obesity
- A high intake of alcohol
Secondary hypertension, on the other hand, has an identifiable underlying medical cause. This type often appears suddenly and can result in higher blood pressure readings than primary hypertension. Conditions such as kidney disease, thyroid problems (both overactive and underactive), and obstructive sleep apnea are common causes of secondary hypertension. Certain medications, including some over-the-counter cold and sinus medicines, pain relievers, and oral contraceptives, can also elevate blood pressure.
Strategies for Long-Term Blood Pressure Management
Once the immediate crisis of a high blood pressure reading is managed, a sustained approach to blood pressure control is important. Regular medical follow-up with a healthcare provider is important to monitor blood pressure levels and adjust treatment plans. Adhering to any prescribed medications, as directed by your doctor, forms a key part of long-term management.
Lifestyle modifications also play a significant role in maintaining healthy blood pressure and preventing future hypertensive episodes. These include:
- Adopting a balanced eating plan, such as the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, and low-fat dairy while limiting saturated fats and cholesterol.
- Reducing sodium intake to less than 2,300 milligrams per day, and ideally to 1,500 milligrams for most adults, helps manage fluid balance and lower blood pressure.
- Engaging in regular physical activity, aiming for at least 150 minutes of moderate-intensity aerobic exercise per week. Activities like brisk walking, cycling, or swimming are beneficial.
- Managing weight, as blood pressure often increases with body weight, also contributes to better blood pressure control.
- Practicing stress reduction techniques.
- Limiting alcohol consumption.
- Quitting smoking.