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Key Takeaways
- Blood pressure is a significant indicator of overall health. A normal blood pressure is 120/80. To be diagnosed with high blood pressure, there must be several consecutive readings of 130/80 or more over time.
- High blood pressure can be managed with medications ordered by a healthcare provider.
- If your blood pressure is higher than 180/120 and you experience symptoms like severe chest pain, shortness of breath, a severe headache, confusion, or blurred vision, it could indicate a hypertensive crisis. Seek emergency medical care immediately or call 911.
When Is Blood Pressure High Enough to Go to the Hospital?
Blood pressure is considered normal when it is at or around 120/80. The top number (120) refers to systolic blood pressure, which measures the force of blood being pushed from the heart and into the arteries for organ perfusion. The bottom number (80) refers to diastolic blood pressure, which measures the force of blood being moved in the arteries when the heart relaxes between beats.
Understanding High Blood Pressure: A Brief Overview
High blood pressure, or hypertension, can often be resolved with the use of medications to lower or stabilize the blood pressure paired with diet and lifestyle modifications. There are many contributing factors including lifestyle, genetics, age, race and various environmental factors. High blood pressure can be detrimental to the body if not addressed in a timely fashion.
Recognizing the Symptoms of High Blood Pressure
Many people with high blood pressure may not experience any symptoms, but when symptoms do occur, they can include shortness of breath, headaches, chest pain, blurry vision, anxiety, dizziness, heart palpitations and even vomiting. These symptoms may signal more serious issues related to high blood pressure.
Certain factors can trigger sudden spikes in blood pressure, including stress, anxiety, missed medications and neurological conditions. Stress and anxiety release hormones that constrict blood vessels as part of the body’s “fight or flight” response, temporarily raising blood pressure. Missing prescribed medications can also lead to spikes, as these drugs help keep blood vessels relaxed and blood pressure stable.
In some cases, neurological conditions may cause sudden blood pressure changes. Damage to the brain’s pathways that control blood vessel constriction can lead to irregular blood pressure levels, resulting in unpredictable spikes or drops.
What Causes High Diastolic Blood Pressure
Diastolic blood pressure is the pressure reading in the arteries when the heart relaxes between beats. Factors causing high diastolic blood pressure include high salt intake, sedentary lifestyle, sleep deprivation, chronic stress, heavy alcohol use and chronic conditions such as kidney disease and hyperthyroidism.
A high diastolic pressure means that the blood vessels aren’t getting the chance to relax between heartbeats. When this occurs, the arteries become stiffer and less elastic over time, causing problems with oxygen delivery and blood flow.
When You Should Go to the Hospital for High Blood Pressure
High blood pressure becomes emergent when it is at or above 180/120 and accompanied by any of the symptoms listed below. This is called hypertensive crisis, which can have detrimental consequences if it is not managed or reported to your healthcare provider immediately. Symptoms of hypertensive crisis include:
- Severe headache
- Confusion
- Chest pain
- Back pain
- Vision changes
- Stroke symptoms which can include numbness, tingling, weakness on one side of the body, facial droop, slurring of words and (sometimes) loss of consciousness
There are also several risk factors associated with hypertensive crisis. These include black or African-American descent, male gender, anyone 65 years of age or older, non-compliance with prescribed blood pressure medications, obesity and various heart conditions.
Identifying a Hypertensive Crisis: Urgency Vs. Emergency
Hypertensive crisis can be divided into two different categories: hypertensive urgency and hypertensive emergency. Hypertensive urgency is defined as having very high blood pressure (180/120) but no signs or symptoms of organ damage. Those experiencing hypertensive urgency will likely not need to visit the hospital, but will need to contact their healthcare provider immediately as they may make some adjustments to their medications. They will also need to monitor themselves for any new or sudden signs or symptoms as this can be a sign of organ damage or other serious conditions.
Hypertensive emergency is defined as having a blood pressure of 180/120 accompanied by signs of organ damage. As listed above, signs of organ damage include chest pain, back pain, severe headaches, confusion, weakness, sudden changes in speech or vision, dizziness and numbness or tingling in the extremities. If anyone is experiencing these symptoms, they need to call 911 and/or go to the hospital immediately for further evaluation and treatment.
- Eclampsia
- Stroke
- Loss of consciousness
- Memory loss
- Heart attack
- Kidney damage or loss of kidney function
- Aortic dissection
- Pulmonary edema (fluid build-up in the lungs)
How is a Hypertensive Crisis Diagnosed and Treated?
There are a variety of tests that the doctor may order to confirm a diagnosis of hypertensive crisis. These tests include:
- Echocardiogram (ultrasound of the heart)
- Chest x-ray
- Electrocardiogram (EKG)
- CT scan of the chest, abdomen, and pelvis
- Labs to test blood counts (hemoglobin, hematocrit, white blood cell counts) and a complete metabolic panel to look for abnormalities in organ function
The physician may also order antihypertensives to be received orally, sublingually (under the tongue) or intravenously. Many of these medications are known to lower the heart rate so symptoms such as lightheadedness, dizziness, nausea, vomiting and vision changes must be quickly reported to the healthcare team. Medications used to treat hypertensive crisis include:
- Hydralazine
- Esmolol
- Nitroglycerine
- Labetalol
- Nitroprusside
Preventing High Blood Pressure and Hypertensive Crises
The best way to manage blood pressure is through healthy eating, lifestyle modifications, and compliance with blood pressure medications. Eat foods that are low in fat, high in fiber and nutrient-dense such as leafy greens, legumes, beets and proteins like grilled or baked chicken. It’s also important to have regular check-ups with a certified healthcare provider and follow up consistently with other specialists such as cardiologists or nephrologists for proper management.
UCF Health Primary Care: Ensuring Your Blood Pressure is in Check
UCF Health Faculty Physician Practice offers primary care services with physicians who provide each patient with personalized care. We also offer cardiology services for severe scenarios requiring specialized knowledge. Our board-certified cardiologists treat conditions such as hypertension, heart failure, coronary artery disease and more.