Blood pressure reflects the force of blood pushing against artery walls as your heart pumps blood. It involves two numbers: systolic pressure (when your heart beats) and diastolic pressure (when your heart rests between beats). Maintaining healthy blood pressure is important, as extremely high levels can threaten organs, including the brain.
Defining Stroke-Risk Blood Pressure
A sudden, severe rise in blood pressure is a hypertensive crisis, significantly increasing stroke risk. Readings of 180/120 millimeters of mercury (mmHg) or higher are considered dangerously high, often called “stroke-level” or “hypertensive crisis.” This term includes two conditions: hypertensive urgency and hypertensive emergency. Hypertensive urgency involves blood pressure at or above 180/120 mmHg without organ damage. While serious, it typically requires prompt medical attention rather than immediate hospitalization.
A hypertensive emergency occurs when blood pressure reaches 180/120 mmHg or higher, accompanied by new or worsening organ damage. This condition is directly associated with a high stroke risk and requires immediate medical intervention to prevent further damage. The term “stroke level” blood pressure most accurately refers to a hypertensive emergency due to the immediate threat of brain injury.
Recognizing a Hypertensive Emergency
Recognizing hypertensive emergency symptoms is important, as they indicate dangerously high blood pressure is harming organs. These symptoms signal a need for immediate medical attention, distinguishing an emergency from a less severe urgency. Neurological symptoms are concerning, suggesting potential brain involvement and increased stroke risk. These include severe headache, confusion, blurred or altered vision, and seizures.
Other physical signs also indicate organ damage. These include chest pain, shortness of breath, and fluid accumulation, such as swelling in the legs, ankles, arms, or hands. Numbness or weakness, especially on one side of the body, and difficulty speaking are also indicators of a hypertensive emergency, often pointing toward a stroke. These symptoms arise because extreme pressure can damage blood vessels in the brain, heart, kidneys, and eyes, leading to dysfunction in these systems.
What to Do During a Hypertensive Crisis
If you or someone you know experiences blood pressure readings of 180/120 mmHg or higher, especially if accompanied by symptoms of organ damage, immediate action is necessary. The most important step is to call emergency services, such as 911, right away. Do not attempt to self-medicate or wait for blood pressure to decrease on its own, as this can lead to rapid and irreversible organ damage.
While waiting for medical help to arrive, it is important to remain as calm as possible. Resting in a quiet environment and focusing on deep, slow breaths can help reduce immediate stress, though these actions are not a substitute for professional medical care. Avoid driving yourself to the hospital if you are experiencing symptoms, and do not take extra doses of your blood pressure medication unless instructed by a healthcare professional. Upon arrival at the emergency room, medical professionals will assess the situation, often administering intravenous medications to gradually lower blood pressure to a safer level and prevent further complications.