A hypertensive crisis occurs when a person's blood pressure becomes dangerously high. This medical emergency can damage organs and blood vessels, and if not treated promptly, the individual is at high risk of having a stroke. The heart may also be unable to supply the body adequately with blood. The term covers two situations: hypertensive urgency and hypertensive emergency. Both conditions require medical care to bring the person's blood pressure back under control.

Hypertensive Urgency

During hypertensive urgency, blood pressure exceeds 180/120. This is less serious than a hypertensive emergency because in a case of hypertensive urgency no damage has yet been done to the organs or blood vessels. During an episode of hypertensive urgency, doctors work to reduce the blood pressure safely using medication. This usually takes a few hours and prevents the condition from progressing to a hypertensive emergency.

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Hypertensive Emergency

A hypertensive emergency is very serious. In a hypertensive emergency, the blood pressure has become so high that organs and blood vessels are already damaged. This situation can be life-threatening, and the person will be admitted to the intensive care unit. Doctors will work to reduce the person's blood pressure to safer levels to prevent any further damage to the organs.

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Causes of Hypertensive Crisis

Often, a hypertensive crisis occurs when a person has missed a few doses of his or her blood pressure medication. However, unexpected interactions between medications can also cause the condition. Some medical situations leave individuals more susceptible to a hypertensive crisis: a stroke or heart attack can cause blood pressure to spike dangerously high, and pregnant women with called eclampsia are also more prone to hypertensive crises.

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Common Symptoms

The most obvious sign of a hypertensive crisis is very high blood pressure. The person may develop a headache and visual disturbances, and experience shortness of breath and pain in the chest. Confusion and disorientation may follow, as well as seizures. As the crisis progresses, fluid may build up in the hands, feet and limbs. This is called edema and causes the body to appear swollen.

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Diagnosing a Hypertensive Crisis

To diagnose a hypertensive crisis, the doctor will ask the person to describe their symptoms and record details of any medications. A history of high blood pressure indicates an increased likelihood of a hypertensive crisis. Tests can assess the severity of the crisis. Medical practitioners will carefully monitor blood pressure over time and may examine the patient's eyes for signs of swelling. Blood and urine tests can help determine the extent of organ damage.

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During either type of hypertensive crisis, the doctors' first aim is to reduce the person's blood pressure as quickly and safely as possible, usually with intravenous blood pressure medicines. Reducing blood pressure can prevent organ damage and complications in a hypertensive urgency and limit the scope of damage in a hypertensive emergency. If organ damage already exists, the patient may require other therapies to repair or reverse the damage once the blood pressure has been brought back under control.

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Complications of Hypertensive Crises

If medical practitioners do not treat a hypertensive crisis promptly, various complications can occur that can be serious and even life-threatening. Once a hypertensive crisis has become a hypertensive emergency, stroke or heart attack is a high possibility. The event can also cause permanent damage to the kidneys and eyes and lead to fluid build-up in the lungs.

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Risk Factors

People already diagnosed with high blood pressure have a greater risk of having a hypertensive crisis, especially if their condition is poorly managed. People with undiagnosed high blood pressure are at a higher risk, understandably, because their blood pressure may reach dangerous levels without them realizing. Pregnant women, particularly those with eclampsia, should have their blood pressure checked regularly to ensure it is not rising to dangerous levels.

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People with diagnosed high blood pressure should take care to keep to their regular medication schedule and monitor their levels regularly to ensure healthy function. People without diagnosed blood pressure should still attend regular health checks and have a doctor take their blood pressure. This way, doctors can note the early signs and treat patients before a crisis occurs.

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When to Seek Help

If blood pressure reaches 180/120 or higher, an individual requires urgent medical help. Anybody exhibiting symptoms of a hypertensive crisis such as chest pain, confusion, disturbed vision, or extreme headaches should immediately seek treatment. In the case of a hypertensive crisis, ambulance transport to the hospital is vital to ensure the person receives medical care as quickly as possible.

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