Have you ever heard of someone suddenly having a very high blood pressure and being rushed to the hospital? Or have you had a similar experience? This is what we medically call a hypertensive crisis or ``Hypertensive Crisis''. This is not something to be trifled with, as it can be life-threatening. So, let's talk about this in a straightforward manner.
What is this hypertensive crisis?
Simply put, this means that your blood pressure suddenly becomes very high. Now, let's look at what a healthy person's blood pressure should be like:
- Upper value (systolic pressure) : less than 120 millimeters of mercury (120 mm Hg)
- Lower value (diastolic pressure) : less than 80 millimeters of mercury (80 mm Hg)
However, during this hypertensive crisis, your blood pressure becomes like this:
- Upper value : 180 mm Hg or more, and/or
- Lower value : 120 mm Hg or more.
This is a medical emergency ! If your blood pressure reaches these levels, you should go to an emergency room (ER) immediately.
Most often, this type of crisis occurs in people who already have high blood pressure (hypertension). That is, their pressure is higher than normal even in everyday life. According to experts, between 1% and 2% of people with high blood pressure can develop this type of crisis. However, it is important to remember that this condition can also occur in people who have never had pressure problems before.
There are two main types of this.
Hypertensive crises can be divided into two main types:
1. Hypertensive urgency : In this case, your blood pressure is very high, but there are no signs of damage to your internal organs (such as your heart, brain, or kidneys). Some doctors also call this "uncontrolled hypertension." Whatever the name, the most important thing is to get your blood pressure back to normal as soon as possible.
2. Hypertensive emergency : This is the most dangerous condition. Here, your blood pressure becomes so high that it causes new damage to your internal organs, or worsens existing damage. For example, organs such as the heart, aorta, eyes, brain, and kidneys can be damaged. Severe preeclampsia and eclampsia, which occur in pregnant women, also fall into this category.
You may have heard the term "malignant hypertension." It was a term that was used in the early 20th century. It meant damage to the kidneys and eyes caused by sudden high blood pressure. Some doctors still use this term when talking about a "hypertensive emergency." But now, "hypertensive emergency" is more commonly used because it has a clearer definition.
What are the symptoms of this hypertensive crisis?
Symptoms depend on whether or not internal organs are damaged.
Hypertensive urgency (increased blood pressure without organ damage)
Most of the time, there are no major symptoms. The only way to know if your blood pressure is too high is to have it measured. However, sometimes you may experience symptoms like:
- Feeling of fear and uneasiness (Anxiety)
- Slight headache
- A little nosebleed
- Slight difficulty breathing
Hypertensive emergency (increased blood pressure with organ damage)
In this case, the symptoms are severe because the organs inside the body are damaged.
- Altered mental status, feeling confused
- Chest pain or a feeling of tightness in the chest
- Dizziness
- Swelling, especially in the legs (edema)
- Heart palpitations
- Less urine output than normal
- Seizures
- A severe, unbearable headache
- Symptoms of a stroke : For example, sudden drooping of one side of the face, slurred speech, or sudden loss of power to an arm or leg (on one side).
- Vision changes : Eyes hurt, sudden loss of vision, or blurred vision.
When a doctor examines you, they may also look for signs like these:
- Jugular venous distention
- Hearing abnormal sounds (crackling) when listening to the lungs
- New, unusual heart sounds that were not present before (heart murmurs)
- Damage to the blood vessels inside the eye (retinal membrane)
- Unusual, asymmetric weakness that raises suspicion of a stroke
What causes this hypertensive crisis?
There are several reasons for this:
- The most common reason is that you are not taking your blood pressure medication correctly, as prescribed by your doctor, and on time. This can happen for any number of reasons (forgetting, running out of medication, not taking it on purpose).
- Stopping blood pressure medication suddenly.
- One medicine you take may interact with another medicine (drug interaction).
- Kidney disease.
- Endocrine issues (hormonal issues).
- Preeclampsia or eclampsia is high blood pressure that occurs during pregnancy.
- Use of certain addictive substances (drugs).
- Severe head injuries (Head trauma).
- A brain tumor.
- Some medications you take for other illnesses.
There are several types of medications that can cause a hypertensive crisis:
- Types of Steroids
- Some medications for depression
- Cyclosporine
- Pseudoephedrine, a component of some cold and flu medications
Who is at higher risk of developing this?
You may be at increased risk of developing this condition if you:
- If your body mass index is high, it means you are obese .
- If you are a man .
- Some international studies have shown that people of African descent are at slightly higher risk. But remember, this condition can affect anyone, of any race.
- If you are someone who doesn't take your blood pressure medication on time .
- If you are using stimulant drugs (e.g. cocaine, amphetamines) that have not been prescribed by a doctor.
What dangerous complications can this cause?
If the pressure becomes dangerously high in this way, it can cause serious complications such as:
- Sudden, rapid heart failure (acute heart failure)
- Sudden filling of the lungs with water (acute pulmonary edema)
- Sudden loss of kidney function (acute kidney failure)
- Tearing or bursting of the largest blood vessel in your body (aorta) (aortic dissection)
- Bleeding into the brain (intracranial hemorrhage)
- A heart attack occurs due to decreased blood flow to the heart.
- An ischemic stroke occurs due to decreased blood flow to the brain.
- Temporary brain dysfunction (`hypertensive encephalopathy`)
All of these things can be life-threatening. That's why we say to be careful about the pressure.
How do doctors diagnose this condition?
A doctor will first measure your blood pressure in both arms to determine if you have a hypertensive crisis. In addition, he or she will ask about your complete medical history (such as previous illnesses and medications you are taking), talk to you about your symptoms, and perform a complete physical examination. Several other tests may be needed to determine the cause.
Types of tests that can be done:
- Blood tests (to check things like kidney function and salt levels)
- Urine tests
- An ``EKG/ECG'' strip that monitors the electrical activity of the heart
- Fundoscopic exam (to check for damage to the blood vessels inside the eye)
- A neurological exam
- An ultrasound scan of the heart (`Transthoracic echocardiogram`)
- Chest and head CT scan
If there are signs of new damage to your internal organs, the doctor will call it a ``hypertensive emergency'', and if there are no such signs, it will be ``hypertensive urgency.''
How is this hypertensive crisis treated?
This is treated in the hospital emergency room . Doctors will give you medication and bring your blood pressure down to a safe level.
- If you have no signs of internal organ damage (i.e., hypertensive urgency), you may be able to go home the same day. But you will be sent home with some medication to take at home.
- However, if you have a ``hypertensive emergency`` (organ damage), you will need to stay in the hospital's intensive care unit (ICU) for a few days. There, doctors will give you intravenous (IV) medication and will continuously monitor your blood pressure.
Your medical team will decide how quickly your blood pressure needs to be lowered. It will depend on the other medical conditions you have. Remember, sometimes lowering your blood pressure too quickly can cause your organs and tissues to lose blood flow. So, it usually takes 24 to 48 hours for your blood pressure to be lowered.
However, if you have special conditions, such as aortic dissection, severe preeclampsia, or eclampsia, doctors will lower your blood pressure more quickly. In such cases, the benefits of lowering your blood pressure quickly far outweigh the small risks.
Some of the medications used for this are `(Captopril)`, `(Clevidipine)`, `(Clonidine)`, `(Esmolol)`, `(Hydralazine)`, `(Labetalol)`, `(Nicardipine)`, `(Nifedipine)`, `(Nitroglycerin)` and `(Nitroprusside)`. Your doctor will choose the medication that is best for you based on your condition, other medications you are taking, and your overall health.
When should I see a doctor?
If your blood pressure is 180/120 mm Hg or higher, call 1990 (emergency number) immediately, or go to the nearest emergency room. You need urgent treatment!
After you have been treated for a high blood pressure crisis like this, see your regular family doctor. He or she may decide to change the dose of your blood pressure medication or add a new medication. He or she will also talk to you about changes you need to make in your daily life (such as diet and exercise). For example, they may advise you to eat a diet low in salt and high in fruits and vegetables (such as the `DASH diet`) and to exercise daily.
What should I expect if this situation arises?
A hypertensive crisis is a serious warning sign that your blood pressure is not well controlled. Your doctor can help you lower your blood pressure and keep it at a healthy level. The most important thing is to keep your appointments and take your medications exactly as they are prescribed.
It's normal to feel scared and anxious when you hear the word "crisis." You might think, "Will my blood pressure ever go up like this again?" Or, "How will this high blood pressure crisis affect my health and my future?"
Just think, there are many reasons why your blood pressure can rise this high. Doctors are trying to figure out what the specific causes are for each person. Once you know the exact cause, you can take steps to reduce the risk of a similar crisis happening again.
This could mean setting a reminder on your phone to remind you to take your medication. Or, it could mean talking to your doctor about any other medications you take and adjusting them if necessary. Remember, every small step you take to control your blood pressure now can go a long way toward reducing your risk of developing serious health problems in the future.
Finally, the most important things to remember (Take-Home Message)
- Know your blood pressure values: What is your normal blood pressure? Know exactly what constitutes an emergency (180/120 mm Hg or higher).
- Take your medication correctly: If your doctor has prescribed you medication for your blood pressure, be sure to take it at the right time and in the right dosage. Don't skip a single day.
- Recognize the warning signs: If you experience symptoms such as severe headache, chest pain, difficulty breathing, vision changes, slurred speech, or loss of limbs, it could be a serious condition.
- Seek immediate medical advice: If you experience any of the above symptoms, or if your blood pressure is 180/120 mm Hg or higher, do not waste time and seek immediate medical advice. Go to a hospital or call 1990.
- Lifestyle changes: A healthy diet (low in salt, oil, and sugar), regular exercise, avoiding smoking, and limiting alcohol consumption can go a long way in controlling your blood pressure.
I hope this information is useful to you. Remember, your health is in your hands. Take care of it!
` High blood pressure, pressure, emergency, blood pressure crisis, symptoms, treatment, heart disease
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න