Hypertensive crisis: What are the symptoms?

By Mayo Clinic Staff
June 19, 2024

What's a hypertensive crisis? If I have a spike in my blood pressure, what should I do?

A hypertensive crisis is a sudden, severe increase in blood pressure. The blood pressure reading is 180/120 millimeters of mercury (mm Hg) or greater. A hypertensive crisis is a medical emergency. It can lead to a heart attack, stroke or other life-threatening health problems. Seek emergency medical help for anyone with these blood pressure numbers.

Severely high blood pressure can damage blood vessels and body organs, including the:

  • Heart.
  • Brain.
  • Kidneys.
  • Eyes.

During a hypertensive crisis, the heart may not be able to pump blood as well as it should.

There are two types of hypertensive crises.

  • Urgent hypertensive crisis. Blood pressure is 180/120 mm Hg or greater. There are no signs of organ damage.
  • Emergency hypertensive crisis. Blood pressure is 180/120 mm Hg or greater. There is life-threatening damage to the body's organs.

Causes of a hypertensive crisis include:

  • Forgetting to take blood pressure medicine.
  • Suddenly stopping certain heart medicines, including beta blockers.
  • Medicine interactions.
  • Tumor of the adrenal gland, called a pheochromocytoma.

Symptoms of a hypertensive crisis may include:

  • Anxiety.
  • Blurred vision.
  • Chest pain.
  • Confusion.
  • Nausea and vomiting.
  • Not responding to stimulation, called unresponsiveness.
  • Seizures.
  • Severe headache.
  • Shortness of breath.

If you get a very high blood pressure reading at home and don't have any symptoms, relax for a few minutes. Then check your blood pressure again. If it's still very high, seek medical care.

Call 911 or emergency medical services if your blood pressure is 180/120 mm Hg or greater and you have chest pain, shortness of breath, or symptoms of stroke. Stroke symptoms include:

  • Numbness or tingling.
  • Loss of feeling in the face, arm or leg, often on just one side of the body.
  • Trouble walking.
  • Trouble speaking.
  • Changes in vision.

Treatment for a hypertensive crisis may include a hospital stay to watch for organ damage. Medicines to lower blood pressure are given by mouth or IV.

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