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

Answer From Francisco Lopez-Jimenez, M.D.

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.

Severely high blood pressure can damage blood vessels and body organs, including the heart, brain, kidneys and eyes. During a hypertensive crisis, the heart may not be able to pump blood effectively.

Hypertensive crises are grouped into two categories.

  • 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 medication
  • Suddenly stopping certain heart medications, such as beta blockers
  • Medication interactions
  • Tumor of the adrenal gland (pheochromocytoma)

Symptoms of a hypertensive crisis may include:

  • Anxiety
  • Blurred vision
  • Chest pain
  • Confusion
  • Nausea and vomiting
  • Not responding to stimulation (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, trouble speaking, or changes in vision.

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

With

Francisco Lopez-Jimenez, M.D.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Aug. 03, 2022 See more Expert Answers

See also

  1. Medication-free hypertension control
  2. Alcohol: Does it affect blood pressure?
  3. Alpha blockers
  4. Amputation and diabetes
  5. Angiotensin-converting enzyme (ACE) inhibitors
  6. Angiotensin II receptor blockers
  7. Anxiety: A cause of high blood pressure?
  8. Arteriosclerosis / atherosclerosis
  9. Artificial sweeteners: Any effect on blood sugar?
  10. AskMayoMom Pediatric Urology
  11. Beta blockers
  12. Beta blockers: Do they cause weight gain?
  13. Beta blockers: How do they affect exercise?
  14. Birth control pill FAQ
  15. Blood glucose meters
  16. Blood glucose monitors
  17. Blood pressure: Can it be higher in one arm?
  18. Blood pressure chart
  19. Blood pressure cuff: Does size matter?
  20. Blood pressure: Does it have a daily pattern?
  21. Blood pressure: Is it affected by cold weather?
  22. Blood pressure medication: Still necessary if I lose weight?
  23. Blood pressure medications: Can they raise my triglycerides?
  24. Blood pressure readings: Why higher at home?
  25. Blood pressure test
  26. Blood pressure tip: Get more potassium
  27. Blood pressure tip: Get off the couch
  28. Blood pressure tip: Know alcohol limits
  29. Blood pressure tip: Stress out no more
  30. Blood pressure tip: Watch the caffeine
  31. Blood pressure tip: Watch your weight
  32. Blood sugar levels can fluctuate for many reasons
  33. Blood sugar testing: Why, when and how
  34. Bone and joint problems associated with diabetes
  35. How kidneys work
  36. Bump on the head: When is it a serious head injury?
  37. Caffeine and hypertension
  38. Calcium channel blockers
  39. Calcium supplements: Do they interfere with blood pressure drugs?
  40. Can whole-grain foods lower blood pressure?
  41. Central-acting agents
  42. Choosing blood pressure medicines
  43. Chronic daily headaches
  44. Chronic kidney disease
  45. Chronic kidney disease: Is a clinical trial right for me?
  46. Coarctation of the aorta
  47. COVID-19: Who's at higher risk of serious symptoms?
  48. Cushing syndrome
  49. DASH diet
  50. DASH diet: Recommended servings
  51. Sample DASH menus
  52. Diabetes
  53. Diabetes and depression: Coping with the two conditions
  54. Diabetes and exercise: When to monitor your blood sugar
  55. Diabetes and heat
  56. 10 ways to avoid diabetes complications
  57. Diabetes diet: Should I avoid sweet fruits?
  58. Diabetes diet: Create your healthy-eating plan
  59. Diabetes foods: Can I substitute honey for sugar?
  60. Diabetes and liver
  61. Diabetes management: How lifestyle, daily routine affect blood sugar
  62. Diabetes: Eating out
  63. Diabetes symptoms
  64. Diabetes treatment: Can cinnamon lower blood sugar?
  65. Using insulin
  66. Diuretics
  67. Diuretics: A cause of low potassium?
  68. Diuretics: Cause of gout?
  69. Dizziness
  70. Do infrared saunas have any health benefits?
  71. Do you know your blood pressure?
  72. Drug addiction (substance use disorder)
  73. Eating right for chronic kidney disease
  74. High blood pressure and exercise
  75. Fibromuscular dysplasia
  76. Free blood pressure machines: Are they accurate?
  77. Home blood pressure monitoring
  78. Glomerulonephritis
  79. Glycemic index: A helpful tool for diabetes?
  80. Guillain-Barre syndrome
  81. Headaches 101: Know your type
  82. Headaches and hormones
  83. Headaches: Treatment depends on your diagnosis and symptoms
  84. Herbal supplements and heart drugs
  85. High blood pressure (hypertension)
  86. High blood pressure and cold remedies: Which are safe?
  87. High blood pressure and sex
  88. High blood pressure: Can you prevent it?
  89. High blood pressure dangers
  90. How does IgA nephropathy (Berger's disease) cause kidney damage?
  91. How opioid addiction occurs
  92. How to tell if a loved one is abusing opioids
  93. What is hypertension? A Mayo Clinic expert explains.
  94. Hypertension FAQs
  95. Hypothermia
  96. I have IgA nephrology. Will I need a kidney transplant?
  97. IgA nephropathy (Berger disease)
  98. Insulin and weight gain
  99. Intracranial hematoma
  100. Isolated systolic hypertension: A health concern?
  101. What is kidney disease? An expert explains
  102. Kidney disease FAQs
  103. Kratom for opioid withdrawal
  104. L-arginine: Does it lower blood pressure?
  105. Late-night eating: OK if you have diabetes?
  106. Lead poisoning
  107. Living with IgA nephropathy (Berger's disease) and C3G
  108. Low-phosphorus diet: Helpful for kidney disease?
  109. Medications and supplements that can raise your blood pressure
  110. Menopause and high blood pressure: What's the connection?
  111. Molar pregnancy
  112. MRI: Is gadolinium safe for people with kidney problems?
  113. New Test for Preeclampsia
  114. Nighttime headaches: Relief
  115. Nosebleeds
  116. Obstructive sleep apnea
  117. Obstructive Sleep Apnea
  118. Pain Management
  119. Pheochromocytoma
  120. Picnic Problems: High Sodium
  121. Pituitary tumors
  122. Polycystic kidney disease
  123. Polypill: Does it treat heart disease?
  124. Porphyria
  125. Postpartum preeclampsia
  126. Preeclampsia
  127. Prescription drug abuse
  128. Primary aldosteronism
  129. Pulse pressure: An indicator of heart health?
  130. Mayo Clinic Minute: Rattlesnakes, scorpions and other desert dangers
  131. Reactive hypoglycemia: What can I do?
  132. Renal diet for vegetarians
  133. Resperate: Can it help reduce blood pressure?
  134. Scorpion sting
  135. Secondary hypertension
  136. Serotonin syndrome
  137. Sleep deprivation: A cause of high blood pressure?
  138. Sleep tips
  139. Vegetable recipes
  140. Blood sugar testing
  141. Snoring
  142. Snoring solution: Sleep on your side
  143. Sodium
  144. Spider bites
  145. Stress and headaches: Stop the cycle
  146. Stress and high blood pressure
  147. Symptom Checker
  148. Takayasu's arteritis
  149. Tapering off opioids: When and how
  150. Tetanus
  151. Tetanus shots: Is it risky to receive 'extra' boosters?
  152. The dawn phenomenon: What can you do?
  153. Infographic: Transplant for Polycystic Kidney Disease
  154. Understanding complement 3 glomerulopathy (C3G)
  155. Understanding IgA nephropathy (Berger's disease)
  156. Vasodilators
  157. Vegetarian diet: Can it help me control my diabetes?
  158. Vesicoureteral reflux
  159. Video: Heart and circulatory system
  160. How diabetes affects your blood sugar
  161. How to measure blood pressure using a manual monitor
  162. How to measure blood pressure using an automatic monitor
  163. Obstructive sleep apnea: What happens?
  164. What is blood pressure?
  165. Can a lack of vitamin D cause high blood pressure?
  166. What are opioids and why are they dangerous?
  167. What's your high blood pressure risk?
  168. White coat hypertension
  169. Wrist blood pressure monitors: Are they accurate?
  170. Effectively managing chronic kidney disease