This problem can happen when high blood pressure is not managed with medicine. Some other problems that may lead to it are:
- Kidney disorders or failure
- Taking some medicines, such as monoamine oxidase inhibitors or birth control pills
- Using drugs, such as cocaine or amphetamines
- Being pregnant and having preeclampsia or eclampsia
- Hormonal problems, such as Cushing disease
- Spinal cord problems
- Coarctation of the aorta
- Narrowing of the arteries to the kidneys
The doctor will ask about your symptoms and health history. A physical exam will be done. Blood pressure readings will be taken.
These tests may be done to look for damage in the body:
- Blood and urine tests
- An EKG to measure the electrical activity in the heart
- An eye exam to look for swelling or bleeding
- Images of the body taken with:
- Chest x-ray
- CT scan
- Echocardiogram or ultrasound of the heart to look for heart damage
- Kidney or bladder ultrasound
This problem needs to be treated right away. Options depend on the damage that has happened.
Medicine will be given to lower blood pressure. It may be given by IV. This lets the medicine quickly lower blood pressure. Options are:
- Sodium nitroprusside or nitroglycerin
- Other vasodilators
A care plan will be made to keep blood pressure at a healthy level. Medicine will need to be part of it.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
Copyright © EBSCO Information Services
All rights reserved.
a (Hypertensive Emergency; Hypertensive Crisis; Hypertensive Urgency)
American Heart Association http://www.heart.org
National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov
Hypertension Canada http://www.hypertension.ca
The Society of Obstetricians and Gynaecologists of Canada https://sogc.org
Varounis C, Katsi V, Nihoyannopoulos P, Lekakis J, Tousoulis D. Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature. Front Cardiovasc Med. 2016;3:51.
Hypertensive crisis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypertensive-crisis . Updated April 17, 2019. Accessed December 3, 2019.
Arbe G, Pastor I, Franco J. Diagnostic and therapeutic approach to the hypertensive crisis. Med Clin (Barc). 2018 Apr 23;150(8):317-22.
Suneja M, Sanders ML. Hypertensive Emergency. Med Clin North Am. 2017 May;101(3):465-78.
Williams B, Mancia G, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33);3021-3104.