Hypertension is the medical term for high blood pressure. Hypertensive crisis occurs when a person’s blood pressure rises to an unusually high level. This condition can cause damage to blood vessels and major organs.
This article discusses some of the causes of the hypertensive crisis and some available treatment options.
It also describes some lifestyle factors that can help lower a person’s blood pressure and reduce their risk of developing a high blood pressure crisis.
Healthcare providers assess blood pressure using a blood pressure meter or blood pressure monitor. This tool produces a reading based on two types of blood pressure: systolic and diastolic.
Systolic pressure refers to the pressure inside the blood vessels, as the heart forces the blood towards the rest of the organs. Diastolic pressure refers to the pressure inside the blood vessels while the heart rests between beats. Blood pressure is measured in millimeters of mercury (mm Hg).
A sphygmomanometer shows the systolic pressure reading above the diastolic pressure reading. If a person has a normal blood pressure, for example, the monitor will show a systolic pressure of less than 120 mm Hg over a diastolic pressure of less than 80 mm Hg.
Hypertension occurs when a person’s blood pressure exceeds normal values. There are two stages of hypertension: stage 1 and stage 2.
Phase 1 hypertension will produce a reading of 130–139 mm Hg above 80–89 mm Hg. Phase 2 hypertension, which is a more severe form, will produce a reading of 140 mm Hg or greater than 90 mm Hg or higher.
According to the Centers for Disease Control and Prevention (CDC), about 45% of adults in the United States have hypertension. They also estimate that only 1 in 4 adults has their hypertension under control.
Uncontrolled hypertension can cause a sudden and severe rise in blood pressure. This increase is known as a hypertensive crisis.
A person experiencing a hypertensive crisis may have a systolic blood pressure reading of 180 mm Hg or higher and a diastolic blood pressure reading of 120 mm Hg or higher.
There are two types of hypertensive crisis: hypertensive urgency and hypertensive emergency.
Hypertensive urgency occurs when a person has the above readings but has no associated symptoms. The hypertensive emergency occurs when a person has the above readings as well as the associated symptoms described below.
About 1-2% of adults with hypertension will experience hypertensive crisis. Some people will experience symptoms, while others will not.
The hypertensive crisis can damage blood vessels and major organs. In 2018 alone, nearly half a million deaths in the U.S. were caused by or contributed to hypertension.
The American Heart Association (AHA) notes that the following medical and life factors may increase the likelihood of hypertension:
The following factors are commonly associated with the hypertensive crisis:
- do not take or forget to take prescribed blood pressure medications
- take medications that interact with each other in a way that raises blood pressure
- consuming illegal drugs such as cocaine or amphetamines
- having a life-threatening cardiovascular disease, such as a stroke or heart attack
- experience organ failure, such as heart or kidney failure
Some people who experience hypertensive crisis may have symptoms, while others may not have any.
People who can check their own blood pressure can see a reading of 180 mm Hg / 120 mm Hg or higher. If there are no other symptoms, the AHA recommends waiting 5 minutes and doing another reading. If the reading is still high, the person should contact their doctor for more advice.
If your blood pressure is high and the person is also experiencing one or more of the following symptoms, someone should call 911 immediately:
A health care provider will perform several blood pressure readings and ask the person about their symptoms and medical history. They will also ask about the medications or supplements the person is taking and whether or not they have used recreational drugs.
If the healthcare professional suspects that there is a risk of organ damage due to a hypertensive crisis, they will arrange for new tests. These may include:
The first-line treatment for hypertensive crisis is usually intravenous antihypertensive drugs to lower a person’s blood pressure. Healthcare providers often try to lower blood pressure by 25% in the first hour, as a rapid drop in blood pressure can cause other problems.
Once a person’s blood pressure is controlled, the health care provider will usually switch to using oral antihypertensive medications.
Medications used by a healthcare provider to lower blood pressure can vary depending on several factors, including:
- whether the person is pregnant or not
- whether or not the person has an underlying illness
- whether or not a hypertensive crisis occurred due to the use of illegal drugs
The most important thing a person with hypertension can do to prevent a hypertensive crisis is to take blood pressure medications exactly as prescribed.
A 2015 study found that people who often did not take blood pressure medications were more likely to be hospitalized for heart problems.
Below are some lifestyle changes that people can make to help lower blood pressure and reduce the risk of developing a high blood pressure crisis.
Eat a healthy diet
A healthy diet is rich in fruits, vegetables and fiber and low in fat and salt. Reducing salt intake can directly lower blood pressure.
The National Heart, Lung, and Blood Institute designed the Dietary Approaches to Stop Hypertension (DASH) diet plan for people who want to lower blood pressure. This is a calorie controlled and heart healthy eating plan that does not require any special food.
Limiting alcohol intake to recommended levels will help lower blood pressure and improve overall health.
The 2020-2025 dietary guidelines for Americans recommend that adults avoid or limit alcohol intake. According to the guidelines, men should not consume more than two drinks a day, while women should not consume more than one drink a day.
Stay physically active
Exercising regularly helps keep the heart and circulatory system healthy. It can also help you lose excess weight, which can also help lower high blood pressure.
The CDC recommends people who want to do 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity each week. However, these figures may vary from person to person.
Smoking increases a person’s blood pressure and increases the risk of cardiovascular problems such as heart attack and stroke.
People who smoke may want to talk to their doctor for advice on how to quit smoking.
Get enough sleep
Good sleep is important for overall health, but it is especially important for the heart and circulatory system. This is because blood pressure drops during sleep.
Adults should aim to sleep at least 7 hours each night. The following factors can help improve a person’s sleep hygiene:
- do a lot of physical activity during the day
- wake up and go to bed at the same time every day
- following a sleep routine
- make sure the sleeping environment is cool, dark, comfortable and free of noise and other distractions
Hypertensive crisis occurs when blood pressure rises to an unusually high level of 180 mm Hg / 120 mm Hg or higher.
A person with a hypertensive crisis may or may not experience symptoms. However, without treatment, the disease can damage blood vessels and major organs.
Factors that can lead to a hypertensive crisis include not taking antihypertensive medications, interactions between certain medications, and illegal drug use. Some underlying health conditions can also trigger hypertensive crisis.
However, there are some steps a person can take to lower their blood pressure and reduce their risk of developing a high blood pressure crisis. These steps include following a healthy diet, reducing alcohol intake, and quitting smoking.
Anyone who wants to get more advice on lowering blood pressure may want to make an appointment with your doctor.