What Is a Hypertensive Crisis?

Blood moves through the walls of the arteries with a certain force. That force is considered the blood pressure. Although a normal adult pressure can vary, an average pressure for an adult is considered to be less than 120 systolic over less than 80 diastolic. About a third of adults in the United States have high blood pressure, according to the American Heart Association. When blood pressure becomes too high, a hypertensive crisis can occur. A crisis can cause a variety of symptoms and complications, such as a stroke.

Facts

• High blood pressure may be considered a reading of 140 over 90, according to the American Heart Association. However, when the blood pressure rises above 180 over 110, it is known as a hypertensive crisis. According to the Cleveland Clinic, about half a million people in the United States are affected by a hypertensive crisis. A hypertensive crisis can lead to serious medical conditions and be life threatening. Medical evaluation from a physician is always needed during a hypertensive crisis.

Considerations

• A hypertensive crisis is usually classified in two categories: urgent and emergency. While both may have similar symptoms and need medical evaluation, an emergency hypertensive crisis involves a more severely elevated blood pressure. According to the Cleveland Clinic, a blood pressure of 180 over 110 is classified as an urgent crisis, while a reading of 220 over 140 is considered an emergency crisis.

Causes

• According to the New York University Langone Medical Center, people who have chronic high blood pressure may develop a hypertensive crisis if they do not take blood pressure medication. Certain drugs, such as cocaine, can cause a sudden increase in blood pressure and lead to a hypertensive crisis. Pregnant women can develop the medical complication eclampsia, which causes a severe increase in blood pressure.

Symptoms

• In addition to increased blood pressure, symptoms of an urgent hypertensive crisis include headache, anxiety and shortness of breath. People who have an emergency hypertensive crisis may develop additional symptoms, such as chest pain and cardiac arrhythmias. An emergency hypertensive crisis may also lead to life-threatening symptoms, such as fluid accumulation in the lungs, which is known as pulmonary edema. This can cause trouble breathing. Other complications that can develop include bleeding in the brain or a stroke, which may cause confusion and seizures.

Treatment

• According to the Cleveland Clinic, treatment will depend not only on the blood pressure measurement, but also on the extent of symptoms. All people who have an emergency hypertensive crisis will need to be hospitalized and monitored closely. Neurological and cardiac tests, such as an electrocardiogram and CAT scan of the head may need to be completed to determine if there is bleeding in the brain or heart arrhythmias. Most hypertensive crises will be treated with medication to lower the blood pressure. Medication may be given intravenously at first and switched to oral medications as the blood pressure is lowered.