Hypertensive crisis

Hypertensive Crisis: What is it?

Hypertensive crisis is a severe and sudden elevation of blood pressure, with systolic blood pressure typically over 180 mmHg or diastolic pressure greater than 110 mmHg. It can be identified as a significant change in blood pressure which is associated with clinical signs and/or symptoms of organ damage, such as headache, nausea or vomiting, vision changes, chest pain, confusion or seizures.

Hypertensive crisis is a medical emergency requiring urgent treatment and hospitalization. It can result in life-threatening organ damage, vision loss, stroke or death.

What are the Symptoms of Hypertensive Crisis?

The symptoms of a hypertensive crisis may vary depending on the severity of the blood pressure, but can include:

  • Severe headache
  • Nausea or vomiting
  • Chest pain
  • Blurred vision
  • Shortness of breath
  • Confusion or difficulty speaking
  • Episodes of unconsciousness (fainting)
  • Seizures

What Causes a Hypertensive Crisis?

Hypertensive crisis is usually caused by an abrupt or sudden increase in blood pressure, often as a result of medication non-adherence, underlying medical conditions, or lifestyle choices, such as excessive alcohol intake, drug abuse, stress, or lack of physical activity.

It can also be caused by medications that increase blood pressure such as non-steroidal anti-inflammatory drugs (NSAIDs), decongestants, diet pills, and certain hormones.

How is a Hypertensive Crisis Treated?

Treatment of a hypertensive crisis is directed towards the underlying cause and the rapid lowering of blood pressure. Intravenous (IV) medications, such as labetalol or nicardipine, are commonly used to quickly decrease blood pressure. If the hypertension is due to medications or drugs, these can be discontinued.

If the patient has underlying medical conditions, such as heart failure or diabetes, these should be addressed. Lifestyle modifications such as weight loss, exercise, smoking cessation, and reducing sodium intake can also help.