What is a Hypertensive Crisis?

A dangerous spike in blood pressure is known as a hypertensive crisis that can lead to a stroke. Extreme high pressure of (top number) 180 systolic and (bottom number)120 diastolic or higher will damage arteries and capillaries. They will become inflamed and leak fluid and/or blood, rendering the heart unable to effectively pump blood under this condition.

What is a Hypertensive Crisis?
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There are two types of hypertensive crisis. One is urgent and the other is an emergency. An urgent hypertensive crisis is when your blood pressure becomes dangerously high and your doctor doesn't suspect any damage to your organs. Symptoms and signs of an urgent hypertensive crisis may include, but not be limited to, shortness of breath, severe anxiety, severe headache, nose bleed and elevated blood pressure.

An emergency hypertensive crisis occurs when pressure becomes dangerously elevated and causes damage to your organs. Life threatening complications as a result of an emergency hypertensive crisis such as pulmonary edema (fluid in the lungs), heart attack, brain bleeding or swelling, stroke, aortic dissection (a tear in the heart's main artery) and eclampsia (high blood pressure with seizures if you are pregnant can occur. If you experience a severe increase in blood pressure, seek immediate medical treatment immediately. Treatment may include hospitalization with oral or intravenous (IV) medications.

To diagnose a hypertensive emergency the health care provider might ask you several questions to understand your medical history. They will also ask you what medications you are taking including prescription, nonprescription medications, recreational drugs and herbal or dietary supplements; a history of other co-morbid conditions and prior cardiovascular or renal disease. Tests will also be conducted to monitor blood pressure and assess organ damage including blood pressure monitoring, blood and urine test and pressure monitoring. Early emergency room triage is top priority to identify those patients who may require more aggressive care in the emergency room. Once a hypertensive emergency has been established the first order of business is to bring the pressure down with intravenous blood pressure medication to prevent further organ damage. Any organ damage that has already occurred will be treated with the appropriate medication and therapies.

Most hypertensive urgencies and emergencies are preventable. They are often the result of inadequately treated or untreated stage I or II hypertension or non adherence to hypertensive therapy. Hypertension affects roughly 50 million people in the United States each year. Hypertensive crisis affects close to 500,000 Americans each year. Approximately 30% of adults are unaware of their hypertension and 40% of the people with hypertension are not receiving treatment. Of those treated up to 67% do not have their blood pressure controlled to less than 140/90.

Hypertension develops at an early age and is more common and severs in African Americans compared to age matched non Hispanic whites. Hypertensive crisis is more common in African Americans compared with other races. The lifetime hypertension risk is 86 to 90% in females and 81 to 83% in men.

The best way to avoid hypertension and hypertensive crisis is to manage your blood pressure through exercise, healthy eating and proper medications when prescribed.


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