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Hypertension Crisis - Causes, Symptoms, Diagnosis, and Treatment

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"Hypertensive crisis" refers to both hypertensive urgency and hypertensive emergency when blood pressure rises to dangerously high levels, causing organ damage.

Medically reviewed by

Dr. Prashant Valecha

Published At November 28, 2022
Reviewed AtJuly 27, 2023

Introduction:

Hypertension is a medical term for high blood pressure and is an urgent condition that is life-threatening. It refers to elevated blood pressure, which at this level confers a high risk of complication. People with raised blood pressure in this range may have no symptoms but are more likely to report dizziness and headaches as compared to general people. Healthcare providers will lower blood pressure and try to prevent organ damage. A sudden rise in arterial blood flow is the main risk factor for the development of cardiovascular disease and can lead to acute vascular damage of vital organs.

What Are the Most Common Causes of Hypertension?

The most common causes seen in chronic hypertension are generally seen due to sudden increases in the flow of blood. Other causes may include the following:

  • Severe stress or anxiety.

  • Irregular intake of medicine.

  • Endocrine issues like adrenal gland tumors.

  • Kidney failure.

  • Thyroid condition.

  • Adrenal disease.

  • Heart disease.

  • Stroke.

  • Cigarette smoking and alcohol abuse.

  • Cocaine and Amphetamine use.

  • Burns, head injury, or any surgery.

  • Side effects of certain drugs like Monoamine Oxidase inhibitors.

What Are the Symptoms of Hypertensive Emergencies?

Hypertensive emergencies suddenly do not show any symptoms other than high blood pressure and possibly a mild headache. They include certain signs and symptoms useful to detect the hypertension crisis, and they are:

  • Loss of consciousness.

  • Confusion, agitation, or seizures.

  • Headaches.

  • Numbness.

  • Blurry vision.

  • Fainting.

  • Chest pain or discomfort.

  • Nausea and vomiting.

  • Shortness of breath.

  • Back pain.

  • Red-colored urine.

What Are the Reasons Responsible for Raised Blood Pressure?

Hypertension crisis is estimated at about three percent of all emergency department visits and risk factors and is present in approximately one billion of the world population and is responsible for an average of 7.1 million deaths annually.

It includes:

  • Lifestyle factors are intake of a high sodium diet, alcohol, and substance abuse.

  • Most common in the male gender.

  • The age factor is that people ages 40 to 50 are more prone to developing the conditions.

  • Pregnancy-related diseases.

  • Diabetes.

  • Anemia.

  • Dyslipidemia (too high or too low blood lipid level).

  • Cardiovascular and renal complications.

What Blood Pressure Reading Denotes Hypertensive Crisis?

A sudden spike in blood pressure indicates a hypertensive crisis:

1) Hypertensive Urgency (Over 180 mmHg or 110-120 mmHg):

  • It may not damage the end-organ, but a gradual reduction in blood pressure over hours or days is a sign to detect.

  • Chronically high blood pressure can cause end-organ if left untreated.

2) Hypertensive Emergency (More than 180-220 mmHg or 120-130 mmHg):

  • The damage to the end-organ to the cerebrovascular, cardiovascular, or renovascular systems begins.

  • Every day blood pressure should be measured to avoid any catastrophic organ damage and done over minutes to hours.

How Is Hypertensive Crisis Diagnosed?

The doctor will take a deep medical history of the patient, which includes medicine intake,

conditions, history or surgery, going through any hospitalization process from the past two years, and whether the patient is undergoing any treatment. They will also measure blood

pressure on both arms several times to detect a single change and make a person risk-free from the hypertensive crisis. The tests may include the following:

  • Electrocardiography: In general language, people are very familiar with the word ECG as it is used to detect any abnormal activity in the heart with the help of electrical impulses.

  • Blood or Urine Tests: To check whether the liver and kidneys are functioning properly, as high blood pressure can damage the kidney.

  • X-ray or Computed Tomography Scan: It is advised if the doctor suspects any end-organ damage.

How Can a Hypertensive Crisis Be Cured?

A hypertensive crisis is a serious condition that can be cured by improving the daily lifestyle of a person along with proper diet, exercise, and medications which will lower the stress and normalize the blood pressure. The immediate motive of treatment is to lower the blood pressure gradually to a safe level. The blood pressure will be reduced but depends on the cause, severity of symptoms, and overall condition of the patient.

Treatment may include:

  1. Oral Medications: If a person is experiencing a sudden rise in blood pressure, oral medication will be administered, and there will be sudden control of the blood pressure.

  2. Intravenous Medications: Generally, intravenous medication is used if any emergency is required as it dissolves in the bloodstream quickly and provides relief.

If the case is not under control and immediate action is required, patients should be hospitalized and treated under intensive care with short-acting antihypertensive drugs, which help to reduce blood pressure with a limit of not more than 25% of the drug dose.

  • Rest: To control the risk of hypertensive crisis, one should take adequate rest as it facilitates a proper balance between the body and the flow of blood pressure.

Hypertensive crisis can be prevented through various major:

  • Daily monitor the blood pressure at home, noting readings and discussing them with the doctor weekly.

  • Take medications as prescribed by the doctor for conditions such as diabetes.

  • It is necessary to confirm with the healthcare provider that the drug taken by an individual does not increase their blood pressure.

  • Limit sodium and potassium intake.

  • Exercise regularly, specifically cardio, to maintain a healthy weight.

  • Control alcohol consumption and smoking.

What Are the Complications of the Hypertension Crisis?

When the blood pressure is very high, it can lead to organ damage, so immediate action should be taken to reduce the blood pressure to prevent imminent organ damage. Organ damage that is linked with hypertension crisis are:

  • Heart failure.

  • Heart attack.

  • Fluid deposits in the lungs.

  • Unstable mental status.

  • Aneurysm (localized swelling and weakening of the artery).

  • Eclampsia (a severe pregnancy complication leading to seizures).

Conclusion:

With the increasing risk of hypertensive crisis, it is very important for people experiencing this crisis to take extra care of themselves by updating a proper reading of blood pressure on a regular basis. This measure can help them in preventing the overall condition and get informed about the severity of the condition so that protective measures can be taken. Also, as mentioned above, by adopting a healthy lifestyle, a person can protect themselves from the risk of hypertensive crisis. People should always be aware of the condition they are going through as a hypertensive crisis does not show many symptoms in a person and can resolve further alarmed strokes.

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Dr. Prashant Valecha
Dr. Prashant Valecha

Cardiology

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