Hypertensive crisis: Difference between revisions

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== Hypertensive Crisis ==
{{SI}}
 
{{Infobox medical condition
[[File:227_over_93_hypertension.jpg|thumb|right|Blood pressure reading indicating a hypertensive crisis]]
| name          = Hypertensive crisis
 
| image          = [[File:227_over_93_hypertension.jpg|250px]]
A '''hypertensive crisis''' is a severe increase in blood pressure that can lead to a [[stroke]]. Extremely high blood pressure a top number (systolic pressure) of 180 millimeters of mercury (mm Hg) or higher or a bottom number (diastolic pressure) of 120 mm Hg or higher can damage blood vessels. The blood vessels become inflamed and may leak fluid or blood. As a result, the heart may not be able to pump blood effectively.
| caption        = Blood pressure reading indicative of a hypertensive crisis
 
| field          = [[Cardiology]]
| symptoms      = Severe [[headache]], [[shortness of breath]], [[nosebleeds]], severe [[anxiety]]
| complications  = [[Stroke]], [[heart attack]], [[kidney damage]], [[aortic dissection]]
| onset          = Sudden
| duration      = Variable
| causes        = Poorly controlled [[hypertension]], [[medication noncompliance]], [[pheochromocytoma]], [[renal artery stenosis]]
| risks          = [[Chronic kidney disease]], [[diabetes mellitus]], [[obesity]], [[smoking]], [[excessive alcohol consumption]]
| diagnosis      = [[Blood pressure]] measurement, [[clinical evaluation]]
| differential  = [[Panic attack]], [[anxiety disorder]], [[pheochromocytoma]]
| prevention    = Regular [[blood pressure monitoring]], [[medication adherence]], [[lifestyle modification]]
| treatment      = [[Antihypertensive medication]], [[hospitalization]]
| medication    = [[Nitroprusside]], [[labetalol]], [[nicardipine]]
| prognosis      = Variable, depends on promptness of treatment
| frequency      = Common in individuals with uncontrolled hypertension
}}
A '''hypertensive crisis''' is a severe increase in blood pressure that can lead to a [[stroke]]. Extremely high blood pressure — a top number (systolic pressure) of 180 millimeters of mercury (mm Hg) or higher or a bottom number (diastolic pressure) of 120 mm Hg or higher — can damage blood vessels. The blood vessels become inflamed and may leak fluid or blood. As a result, the heart may not be able to pump blood effectively.
== Types of Hypertensive Crisis ==
== Types of Hypertensive Crisis ==
There are two types of hypertensive crises: [[hypertensive urgency]] and [[hypertensive emergency]].
There are two types of hypertensive crises: [[hypertensive urgency]] and [[hypertensive emergency]].
=== Hypertensive Urgency ===
=== Hypertensive Urgency ===
In a hypertensive urgency, blood pressure is extremely high, but there is no associated organ damage. Patients may experience severe headaches, shortness of breath, or nosebleeds, but these symptoms are not life-threatening. Treatment often involves oral antihypertensive medications and close monitoring.
In a hypertensive urgency, blood pressure is extremely high, but there is no associated organ damage. Patients may experience severe headaches, shortness of breath, or nosebleeds, but these symptoms are not life-threatening. Treatment often involves oral antihypertensive medications and close monitoring.
=== Hypertensive Emergency ===
=== Hypertensive Emergency ===
A hypertensive emergency is a situation where high blood pressure results in damage to organs. This can include [[encephalopathy]], [[myocardial infarction]], [[pulmonary edema]], or [[aortic dissection]]. Immediate hospitalization and intravenous antihypertensive medications are required to prevent further organ damage.
A hypertensive emergency is a situation where high blood pressure results in damage to organs. This can include [[encephalopathy]], [[myocardial infarction]], [[pulmonary edema]], or [[aortic dissection]]. Immediate hospitalization and intravenous antihypertensive medications are required to prevent further organ damage.
== Causes ==
== Causes ==
Hypertensive crises can be caused by a variety of factors, including:
Hypertensive crises can be caused by a variety of factors, including:
* [[Chronic hypertension]]
* [[Chronic hypertension]]
* [[Renal artery stenosis]]
* [[Renal artery stenosis]]
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* [[Medication noncompliance]]
* [[Medication noncompliance]]
* [[Drug interactions]]
* [[Drug interactions]]
== Symptoms ==
== Symptoms ==
Symptoms of a hypertensive crisis can vary depending on the severity and type. Common symptoms include:
Symptoms of a hypertensive crisis can vary depending on the severity and type. Common symptoms include:
* Severe headache
* Severe headache
* Shortness of breath
* Shortness of breath
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* Confusion
* Confusion
* Blurred vision
* Blurred vision
== Diagnosis ==
== Diagnosis ==
Diagnosis of a hypertensive crisis involves measuring blood pressure and assessing for signs of organ damage. Additional tests may include:
Diagnosis of a hypertensive crisis involves measuring blood pressure and assessing for signs of organ damage. Additional tests may include:
* [[Electrocardiogram]] (ECG)
* [[Electrocardiogram]] (ECG)
* [[Blood tests]]
* [[Blood tests]]
* [[Urinalysis]]
* [[Urinalysis]]
* [[Imaging studies]] such as [[CT scan]] or [[MRI]]
* [[Imaging studies]] such as [[CT scan]] or [[MRI]]
== Treatment ==
== Treatment ==
The treatment of a hypertensive crisis depends on whether it is a hypertensive urgency or emergency. In a hypertensive urgency, oral medications such as [[labetalol]], [[captopril]], or [[clonidine]] may be used. In a hypertensive emergency, intravenous medications such as [[nitroprusside]], [[nicardipine]], or [[labetalol]] are administered.
The treatment of a hypertensive crisis depends on whether it is a hypertensive urgency or emergency. In a hypertensive urgency, oral medications such as [[labetalol]], [[captopril]], or [[clonidine]] may be used. In a hypertensive emergency, intravenous medications such as [[nitroprusside]], [[nicardipine]], or [[labetalol]] are administered.
== Prevention ==
== Prevention ==
Preventing a hypertensive crisis involves managing [[hypertension]] through lifestyle changes and medication adherence. Regular monitoring of blood pressure, maintaining a healthy diet, regular exercise, and avoiding tobacco and excessive alcohol can help prevent hypertensive crises.
Preventing a hypertensive crisis involves managing [[hypertension]] through lifestyle changes and medication adherence. Regular monitoring of blood pressure, maintaining a healthy diet, regular exercise, and avoiding tobacco and excessive alcohol can help prevent hypertensive crises.
 
== See also ==
== Related Pages ==
 
* [[Hypertension]]
* [[Hypertension]]
* [[Stroke]]
* [[Stroke]]
* [[Heart failure]]
* [[Heart failure]]
* [[Kidney disease]]
* [[Kidney disease]]
{{Hypertension}}
{{Hypertension}}
[[Category:Cardiovascular diseases]]
[[Category:Cardiovascular diseases]]
[[Category:Medical emergencies]]
[[Category:Medical emergencies]]

Latest revision as of 03:56, 7 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Hypertensive crisis
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Severe headache, shortness of breath, nosebleeds, severe anxiety
Complications Stroke, heart attack, kidney damage, aortic dissection
Onset Sudden
Duration Variable
Types N/A
Causes Poorly controlled hypertension, medication noncompliance, pheochromocytoma, renal artery stenosis
Risks Chronic kidney disease, diabetes mellitus, obesity, smoking, excessive alcohol consumption
Diagnosis Blood pressure measurement, clinical evaluation
Differential diagnosis Panic attack, anxiety disorder, pheochromocytoma
Prevention Regular blood pressure monitoring, medication adherence, lifestyle modification
Treatment Antihypertensive medication, hospitalization
Medication Nitroprusside, labetalol, nicardipine
Prognosis Variable, depends on promptness of treatment
Frequency Common in individuals with uncontrolled hypertension
Deaths N/A


A hypertensive crisis is a severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure — a top number (systolic pressure) of 180 millimeters of mercury (mm Hg) or higher or a bottom number (diastolic pressure) of 120 mm Hg or higher — can damage blood vessels. The blood vessels become inflamed and may leak fluid or blood. As a result, the heart may not be able to pump blood effectively.

Types of Hypertensive Crisis[edit]

There are two types of hypertensive crises: hypertensive urgency and hypertensive emergency.

Hypertensive Urgency[edit]

In a hypertensive urgency, blood pressure is extremely high, but there is no associated organ damage. Patients may experience severe headaches, shortness of breath, or nosebleeds, but these symptoms are not life-threatening. Treatment often involves oral antihypertensive medications and close monitoring.

Hypertensive Emergency[edit]

A hypertensive emergency is a situation where high blood pressure results in damage to organs. This can include encephalopathy, myocardial infarction, pulmonary edema, or aortic dissection. Immediate hospitalization and intravenous antihypertensive medications are required to prevent further organ damage.

Causes[edit]

Hypertensive crises can be caused by a variety of factors, including:

Symptoms[edit]

Symptoms of a hypertensive crisis can vary depending on the severity and type. Common symptoms include:

  • Severe headache
  • Shortness of breath
  • Nosebleeds
  • Severe anxiety
  • Chest pain
  • Confusion
  • Blurred vision

Diagnosis[edit]

Diagnosis of a hypertensive crisis involves measuring blood pressure and assessing for signs of organ damage. Additional tests may include:

Treatment[edit]

The treatment of a hypertensive crisis depends on whether it is a hypertensive urgency or emergency. In a hypertensive urgency, oral medications such as labetalol, captopril, or clonidine may be used. In a hypertensive emergency, intravenous medications such as nitroprusside, nicardipine, or labetalol are administered.

Prevention[edit]

Preventing a hypertensive crisis involves managing hypertension through lifestyle changes and medication adherence. Regular monitoring of blood pressure, maintaining a healthy diet, regular exercise, and avoiding tobacco and excessive alcohol can help prevent hypertensive crises.

See also[edit]