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Hypertensive crisis: What are the symptoms?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/hypertensive-crisis/AN00626
- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
read biographyclose windowBiography of
Sheldon G. Sheps, M.D.
Sheldon Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.
Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.
In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Question
Hypertensive crisis: What are the symptoms?
What's a hypertensive crisis? If I notice a spike in my blood pressure, what should I do?
Answer
from Sheldon G. Sheps, M.D.
A hypertensive crisis is a severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure — a systolic (top number) blood pressure of 180 millimeters of mercury (mm Hg) or higher or a diastolic (bottom number) blood pressure of 120 mm Hg or higher — damages blood vessels. They become inflamed and may leak fluid or blood. As a result, the heart may not be able to pump blood effectively.
Causes of a hypertensive emergency include:
- Forgetting to take your blood pressure medication
- Stroke
- Heart attack
- Heart failure
- Kidney failure
- Rupture of your body's main artery (aorta)
- Interaction between medications
- Convulsions during pregnancy (eclampsia)
A hypertensive crisis is divided into two categories: urgent and emergency. In an urgent hypertensive crisis, your blood pressure is extremely high, but your doctor doesn't suspect you have any damage to your organs. In an emergency hypertensive crisis, your blood pressure is extremely high and has caused damage to your organs. An emergency hypertensive crisis can be associated with life-threatening complications.
Signs and symptoms of a hypertensive crisis that may be life-threatening may include:
- Severe chest pain
- Severe headache, accompanied by confusion and blurred vision
- Nausea and vomiting
- Severe anxiety
- Shortness of breath
- Seizures
- Unresponsiveness
If you experience a severe increase in your blood pressure, seek immediate medical attention. Treatment for hypertensive crisis may include hospitalization for treatment with oral or intravenous (IV) medications.
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- Rodriguez MA, et al. Hypertensive crisis. Cardiology in Review. 2010;18:102.
- Hays AJ, et al. Management of hypertensive emergencies: A drug therapy perspective for nurses. AACN Advanced Critical Care. 2010;21:5.
- Kaplan NM, et al. Treatment of specific hypertensive emergencies. http://www.uptodate.com/home/index.html. Accessed May 10, 2011.
- Bakris GL. Management of severe asymptomatic hypertension (hypertensive urgencies). http://www.uptodate.com/home/index.html. Accessed May 10, 2011.
- Chobanian AV, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. New England Journal of Medicine. 2003;289:2560.
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