Blood pressure measures the force of blood against artery walls as your heart pumps blood. It’s expressed as two numbers: systolic (heart beats) and diastolic (heart rests between beats). Monitoring blood pressure is important for overall health, as fluctuations can indicate underlying issues. While blood pressure numbers can vary throughout the day due to activity or stress, extremely high readings can signal a serious medical concern.
Identifying a Hypertensive Crisis
A hypertensive crisis is a medical emergency requiring immediate attention. It occurs when blood pressure reaches 180/120 millimeters of mercury (mmHg) or higher, accompanied by severe symptoms indicating acute organ damage.
Symptoms include severe headache, shortness of breath, chest pain, vision changes, numbness or weakness, difficulty speaking, severe anxiety, or a nosebleed that will not stop. If you experience these symptoms with blood pressure readings of 180/120 mmHg or higher, call 911 or go to the nearest emergency room immediately. Ignoring these signs can lead to life-threatening complications involving the heart, lungs, or brain.
Understanding Hypertensive Urgency
Hypertensive urgency is a situation where blood pressure is severely elevated, at or above 180/120 mmHg, but without signs of acute organ damage. While the numbers are the same as in a hypertensive crisis, the absence of symptoms like severe headache, chest pain, or vision changes differentiates it. Some healthcare providers may refer to this condition as uncontrolled hypertension.
This condition is not an immediate emergency room visit, but it still requires prompt medical attention. Contact your doctor or visit an urgent care facility right away to have your blood pressure assessed and medication adjusted if necessary. Delaying care for hypertensive urgency can lead to serious health problems, including progression to a hypertensive crisis.
What to Expect During an ER Visit
Upon arrival at the emergency room for severely high blood pressure, medical staff will perform an initial assessment. This includes checking your blood pressure, reviewing your medical history, and evaluating any symptoms you are experiencing. The goal is to determine the cause of the high blood pressure and check for any signs of organ damage.
To assess for potential organ damage, various diagnostic tests may be performed. These can include blood tests to check kidney function and electrolyte levels, and urine tests. An electrocardiogram (ECG or EKG) may be done to evaluate heart activity, and imaging tests like a chest X-ray, CT scan, or echocardiogram might be used to examine the heart, lungs, or blood vessels.
Treatment in the ER focuses on safely and gradually lowering your blood pressure. Medications, often administered intravenously, are used to achieve this controlled reduction, as lowering blood pressure too quickly can be harmful. The specific medications and the rate of reduction depend on your condition and any other medical issues. After your blood pressure is stabilized, you will be advised to follow up with your primary care physician or a cardiologist to manage your blood pressure long-term and prevent future episodes.