When Should You Treat High Blood Pressure As An Emergency?
Written by Eli Ben-YehudaOn May 28, 2019
Hypertensive crisis and high blood pressure
The World Health Organization has estimated that high blood pressure causes one in every eight deaths, making hypertension the third leading killer in the world. Globally, there are one billion hypertensives and four million people die annually as a direct result of hypertension.
High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.
Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.
You can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.
Normal blood pressure for adults is defined as a systolic pressure below 120 mmHg and a diastolic pressure below 80 mmHg. It is normal for blood pressures to change when you sleep, wake up, or are excited or nervous. When you are active, it is normal for your blood pressure to increase. However, once the activity stops, your blood pressure returns to your normal baseline range.
What is a hypertensive crisis?
A “Hypertensive Crisis” can be life threatening and is a very scary thing to experience. I have been there and I do not want to experience it again. But what is a “Hypertensive Crisis”?
A hypertensive crisis is a severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure, a top number (systolic pressure) of 180 millimeters of mercury (mm Hg) or higher or a bottom number (diastolic pressure) of 120 mm Hg or higher, can damage blood vessels. The blood vessels become inflamed and may leak fluid or blood. As a result, the heart may not be able to pump blood effectively.
What is the cause of hypertensive crisis?
Hypertensive crises are a common cause of medical urgencies or emergencies diagnosed in emergency rooms. Identification of risk factors for development of hypertensive crisis is important, so that specific patients at increased risk can be targeted for more aggressive therapy.
Those at risk for hypertensive crisis include patients with primary hypertension, a condition in which the cause of high blood pressure is unknown, and patients with secondary hypertension, high blood pressure that accompanies conditions such as renal disease, cardiovascular disease, sleep apnea, or pheochromocytoma.
A crisis in hypertensive patients can also be triggered by surgery, excess dietary salt intake, or a worsening of existing hypertension that goes undetected. In patients with or without existing hypertension, a hypertensive crisis can be triggered by neurological conditions, alcohol withdrawal, the use of illegal drugs like cocaine, or taking over-the-counter preparations that contain pseudoephedrine.
A hypertensive crisis is known to occur more commonly in males and in African-Americans. In addition, hypertensive crises are known to occur with a peak incidence between the ages of 40 and 50 years.
Signs & Symptoms of Hypertensive Crisis:
- Severe chest pain
- Severe headache, accompanied by confusion and blurred vision
- Nausea and vomiting
- Severe anxiety
- Shortness of breath
If you experience a severe increase in your blood pressure, seek immediate medical attention immediately or call 911. Treatment for hypertensive crisis may include hospitalization for treatment with oral or intravenous medications.
Causes Of Hypertensive Crisis:
- Forgetting to take your blood pressure medication
- Heart attack
- Heart failure
- Kidney failure
- Rupture of your body’s main artery (aorta)
- Interaction between medications
- Convulsions during pregnancy (eclampsia)
Commonly affected organs/systems include:
- Central Nervous System
- Findings include Hypertensive encephalopathy, subarachnoid or intracerebral hemorrhage. In other words, it can cause a stroke or bleed in the brain.
- Symptoms include: seizures, altered mental status (lethargy, coma, confusion), change in behavior, facial nerve palsy, hemiplegia
- Findings include: renal insufficiency/failure
- Symptoms include: flank pain, dysuria, hematuria, frothy or tea-colored urine, oliguria/anuria
- Note: often renal disease is the cause of hypertension in children, but rarely hypertension in children can lead to kidney damage as described above
- Findings include: congestive heart failure
- Symptoms include: tachypnea, shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, edema, S3 or S4, new or changed heart murmur
- Findings include: papilledema, retinal hemorrhages, exudates
- Symptoms include: visual changes, deficits in peripheral vision
Educating yourself concerning is the biggest key to preventing a hypertensive crisis. If you have hypertension there are ways to control it, so that you are not faced with this problem. There are also ways that you can personally take responsibility for your hypertension. Just like a diabetic that avoids chocolate cake, there are things you should avoid. We all need to become our own healthcare advocates.
Things You Can Do To Help Yourself:
- If you are overweight lose the weight. For every 20 lbs you lose you can drop your systolic blood pressure 5-20 points.
- Quitting Smoking can naturally lower your blood pressure 5-10 points.
- Getting more exercise can lower your numbers 5-15 points.
- Decreasing caffeine intake lowers your diastolic pressure by 4-13 points
- Decrease alcohol intake lowers your numbers 2-4 points.
- Avoiding all processed foods lowers your numbers 10 points.
- Decrease salt intake or stop altogether up to 25 Points.
- Eat more fruits and vegetables
- If your physician has prescribed medication, take as directed
- Monitor your own blood pressure at home.
You do not have to experience a hypertensive crisis like I did. Although I did not see it coming and did not know I had hypertension, to begin with. A hypertensive crisis is dangerous and not to be taken lightly. But you have the power to make a difference in your own health.
Have an idea for a article? We would love to hear from you. Contact me, Eli, at [email protected]
Related Books on Hypertensive Crisis for Further Reading:
- Prevent and Reverse Heart Disease. by Caldwell B. Esselstyn Jr. M.D
- How Not To Die. by Michael Greger M.D
- The End of Heart Disease. by Joel Fuhrman M.D
- The End of Diabetes. by Joel Fuhrman M.D
Further articles on Hypertensive Crisis related topics:
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