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Patient education: High blood pressure emergencies (The Basics)

What is a high blood pressure emergency?A high blood pressure emergency is a serious – and even life-threatening – condition that can happen when a person's blood pressure gets much higher than normal. When a person's blood pressure gets very high, it can lead to problems in one or more of the following organs:

●Eyes – Problems can include bleeding in the back of the eye, or swelling of the nerve that runs from the eye to the brain.


●Brain – Problems can include swelling or bleeding in the brain, or a stroke. A stroke is when a part of the brain is damaged because of a problem with blood flow.


●Kidneys – Very high blood pressure can lead to kidney failure, which is when the kidneys stop working.


●Heart – Heart problems can include a heart attack, heart failure, or damage to a major blood vessel.


When your doctor or nurse tells you your blood pressure, they say 2 numbers. For example, your doctor might say that your blood pressure is "140 over 90." When people have a high blood pressure emergency, their blood pressure is usually "180 over 120" or higher.

Other terms doctors might use for a high blood pressure emergency are "hypertensive emergency" or "malignant hypertension."

Sometimes, a person's blood pressure is much higher than normal, but it hasn't damaged any organs. Doctors call this "hypertensive urgency." Hypertensive urgency is not usually treated the same as a high blood pressure emergency.

What are the symptoms of a high blood pressure emergency?The symptoms depend on the organ or organs affected. They can include:

●Blurry vision or other vision changes

●Headache

●Nausea or vomiting

●Confusion

●Passing out or seizures – Seizures are waves of abnormal electrical activity in the brain that can make people move or behave strangely.

●Weakness or numbness on one side of the body, or in one arm or leg

●Difficulty talking

●Trouble breathing

●Chest pain

●Pain in the upper back or between the shoulders

●Urine that is brown or bloody

●Pain in the lower back or on the side of the body


Should I see a doctor or nurse?Yes. Call your doctor or nurse right away if you have any of the symptoms listed above, especially if you know that you have high blood pressure.

Will I need tests?Yes. Your doctor or nurse will ask about your symptoms, do an exam, and check your blood pressure. They might use a special light to look in the back of your eyes.

Your doctor will also do tests to check how serious your condition is. Tests can include:

●Blood tests

●Urine tests

●A chest X-ray

●A CT scan or other imaging test of your brain – Imaging tests create pictures of the inside of the body.

●A CT scan or other imaging test of your chest

●An ECG (also called an "electrocardiogram") – This test measures the electrical activity in your heart (figure 1).


How is a high blood pressure emergency treated?A high blood pressure emergency is treated in the hospital. Your doctor will give you medicines to lower your blood pressure quickly. These medicines are usually given through a thin tube that goes into your vein, called an "IV."

Your doctor will also treat any problems caused by your very high blood pressure, if they can be treated.

People who have a high blood pressure emergency usually need long-term treatment to keep their blood pressure under control. This usually includes:

●Taking medicines

●Following a low-salt diet that includes a lot of fruits and vegetables

●Losing weight (if you are overweight)

●Getting regular exercise

All topics are updated as new evidence becomes available and our peer review process is complete.

This topic retrieved from UpToDate on: May 17, 2021.

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of UpToDate content is governed by the UpToDate Terms of Use. ©2021 UpToDate, Inc. All rights reserved.

Topic 17188 Version 7.0

Reference

Uptodate. (2021). Patient education: High blood pressure emergencies (The Basics). Retrived from https://www.uptodate.com/contents/high-blood-pressure-emergencies-the-basics?search=hypertension&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

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