Sudden Hypertension
Medically referred to as a hypertensive crisis, sudden hypertension is characterized by a sharp increase in blood pressure readings. Specifically, this occurs when the systolic blood pressure reaches 180 mmHg or higher, or the diastolic blood pressure reaches 120 mmHg or exceeds this level. This condition is extremely serious, potentially leading to various health complications, and requires immediate medical attention.
Causes of Sudden Hypertension
Sudden hypertension can arise from a simple cause such as forgetting to take a prescribed antihypertensive medication. However, a variety of factors can contribute, as detailed below:
- Experiencing a stroke or heart attack.
- Heart failure.
- Kidney failure.
- Aortic dissection, which involves a tear in one of the body’s major arteries.
- Drug interactions or side effects.
- Preeclampsia leading to eclampsia during pregnancy.
- Cocaine use.
- Hyperthyroidism or hypothyroidism.
Types of Sudden Hypertension
Hypertensive Urgency
Hypertensive urgency is defined as a blood pressure reading of 180/120 mmHg or higher without any accompanying symptoms indicating organ damage. In this case, the patient should wait for five minutes after the initial reading and then recheck the blood pressure. If high readings persist without additional symptoms, it is generally safe to lower blood pressure gradually over several hours using antihypertensive medications. The healthcare provider may adjust or add medications for the patient, and hospitalization is rarely necessary.
Hypertensive Emergency
Hypertensive emergency, previously referred to as malignant hypertension, is characterized by blood pressure readings of 180/120 mmHg or higher, accompanied by symptoms pointing to organ damage. These symptoms could include brain hemorrhage, heart attack, pulmonary edema, or the presence of an aneurysm. Additional signs indicating potential organ damage may include:
- Changes in mental status, such as confusion or speech difficulties.
- Shortness of breath.
- Back pain.
- Chest pain.
- Numbness or tingling sensations.
- Vision changes.
- Edema, which is swelling from fluid accumulation in body tissues.
- Seizures.
It is crucial to call emergency services immediately if any of the aforementioned symptoms occur, rather than waiting for blood pressure to normalize on its own. To diagnose hypertensive emergency, the healthcare provider will inquire about all medications the patient is taking, including over-the-counter drugs, and any supplements or herbs. Regular blood pressure monitoring will be conducted, along with various tests such as eye exams and bloodwork. Upon confirming the diagnosis, it is essential to lower blood pressure promptly using intravenous antihypertensive medications to prevent further organ damage. Possible intravenous options include sodium nitroprusside and nitroglycerin.
Once the patient’s condition stabilizes, several additional tests may be performed to ensure there is no severe damage or bleeding. These tests can include ultrasound, computed tomography (CT) scans, and magnetic resonance imaging (MRI). Before discharging the patient from the hospital, the physician may prescribe medications for blood pressure control if not already on a regimen. To prevent future hypertensive emergencies, individuals with high blood pressure should consistently monitor their readings and adhere to medication schedules, alongside maintaining a healthy lifestyle and following medical advice. Addressing any underlying issues that could elevate the risk of future hypertensive crises is also critical.
Blood Pressure Readings Explained
Understanding the implications of various blood pressure readings is essential for identifying what falls within normal ranges and what necessitates medical evaluation. According to the American Heart Association, blood pressure categories are as follows:
- Normal: Blood pressure readings of less than 120/80 mmHg. Individuals in this category are advised to continue healthy habits, including a balanced diet and regular exercise.
- Elevated: This category includes systolic readings between 120-129 mmHg, with diastolic readings remaining below 80 mmHg. Those in this range are at risk of developing hypertension if preventative actions are not taken.
- Stage 1 Hypertension: Systolic blood pressure readings between 130-139 mmHg or diastolic readings between 80-89 mmHg. Patients are advised to implement lifestyle changes, and medication may be prescribed.
- Stage 2 Hypertension: Blood pressure readings of 140 mmHg or higher for systolic or 90 mmHg or higher for diastolic. Patients in this stage typically require multiple medications along with lifestyle modifications to manage their condition.
Video on Causes of High Blood Pressure
Watch this video to learn more about the causes of high blood pressure: