Hypertensive and Hypotensive Crises| What You Should Know

Date Created: 02/20/2017
By Christopher Hamann, M.D., ABEM, ACEP

blood pressure

Roughly 75 million people in the United States suffer from high blood pressure— are you one of them? If you’re not sure, and you don’t know your family history, you should consult your physician immediately. In addition to being an extremely common condition, effecting roughly 29% of the population, extremely high or extremely low blood pressure can become fatal. So, what is a safe range for blood pressure, and when should you be concerned?

Blood Pressure Chart

There are two types of conditions when it comes to blood pressure issues. These are commonly referred to as hypertension, or high blood pressure, and hypotension, or low blood pressure. Undiagnosed hypertension or hypotension can be very sinister, quietly damaging your body for many years without you even being aware of it, which also puts you at higher risk of developing a number of other medical conditions.

While high or low blood pressure varies by age, race, and genetic predisposition, it can be controlled.  People who have blood pressure issues and who are not aggressive with treating it can put themselves in danger.

Hypertensive Urgency and Hypertensive Crisis

A hypertensive urgency happens when a person’s blood pressure is greater than 180/120 mm Hg and can be classified as either hypertensive urgency or hypertensive emergency.

Hypertensive urgency has no associated target organ damage, whereas hypertensive emergency can feature neurologic, aortic, cardiac, and/or pregnancy-related damage, to name a few.

Spikes in blood pressure don’t necessarily mean you need to go to the ER. According to WebMD, in a study conducted by the Cleveland Clinic, of roughly 60,000 patients diagnosed with “hypertensive urgency” (very high blood pressure) during an office visit, less than 1% needed a referral to a hospital ER. While it can be extremely scary to have hypertensive urgency, there are several things to consider.

Hypertensive urgency is NOT the same as a hypertensive crisis, characterized by hypertensive urgency and symptoms such as headache, blurred vision or other visual changes, and/or chest pain. If you believe you’re experiencing a hypertensive crisis, seek immediate emergency medical attention. If you’re experiencing hypertensive urgency with no other symptoms, you still should still contact your doctor or medical professional as soon as possible.

Hypertension Risks

Signs and Symptoms of Hypotension

Like high blood pressure, low blood pressure isn’t cause for immediate concern unless it too is accompanied by symptoms and in some cases, severe hypotension is linked to shock.

This means that not enough blood and oxygen flow to the body's major organs, including the brain. The early signs and symptoms of reduced blood flow to the brain include:

Damage from Hypotension

The earliest stages of shock may be hard to detect with regards to signs or symptoms, but over time the symptoms can worsen. For example, a person won't be able to sit up without passing out and if the shock continues, the person will lose consciousness. Shock often is fatal if not treated right away.

If you or a loved one needs emergency medical attention, you have options beyond the hospital ER. GuideWell Emergency Doctors is staffed by board-certified emergency medicine doctors and offers many of the same on-site services as a hospital— including lab work and diagnostic testing— but at one-third the cost of a hospital visit, on average. Open seven days a week, no appointment needed, at three different locations in the Orlando area. GuideWell Emergency Doctors: something new, something better, in emergency care.

Christopher Hamann, M.D., ABEM, ACEP

Dr. Hamann is board certified with the American Board of Emergency Medicine. He is a graduate of the Medical College of Wisconsin and completed his residency in Emergency Medicine at the University of Florida HSC, Jacksonville, Florida. Dr. Hamann has held positions as Staff Physician at Cleveland Clinic Hospital-Naples and as Assistant Director of Emergency Medicine at Physicians Regional Medical System in Naples, Florida. Dr. Hamann has many interests including architecture, landscape design, surfing, paddle boarding, mountain biking, cooking, and baking. He and his wife, Lisa, have two daughters.

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