Hypertensive crisis

What is a hypertensive crisis?

In a hypertensive crisis, blood pressure rises very quickly to critical levels. These exceed 230 mmHg (say, mm Hg) for systolic pressure and 130 mmHg for diastolic blood pressure. Normally, a healthy blood pressure is about 120 to 80 mmHg.

Medical professionals limit the terms Hypertensive crisis and hypertensive emergency from each other. While blood pressure is alarmingly high in hypertensive crisis, there are still no symptoms suggestive of organ damage. In contrast, in a hypertensive emergency mortal danger, since already organ damage occurred. A hypertensive crisis, especially if not treated on time, can quickly turn into a hypertensive emergency.

Hypertensive crisis: causes

A hypertensive crisis can have many causes. It usually occurs in connection with an existing hypertension (primary or secondary arterial hypertension), sometimes associated with the sudden withdrawal of antihypertensives.

Only rarely is hypertensive crisis seen in people who otherwise have normal blood pressure. Then, for example, an acute renal corollary (acute glomerulonephritis) or eclampsia may be the cause. Likewise, at certain Diseases of hormone-forming organs suddenly released a large amount of blood pressure messenger substances, which raises the blood pressure within minutes to dangerous levels. This can happen, for example, in pheochromocytoma (a tumor of the adrenal medulla).

Rarer introduces alcohol withdrawal or substance abuse (Cocaine, amphetamines) to a blood pressure crisis.

Hypertensive crisis: signs

Hypertensive crisis does not always cause clear symptoms. Especially in people who have been hypertensive for some time, the complaints are often uncharacteristic. The following symptoms may indicate a hypertensive derailment:

• Red head
• Headache or extreme pressure in the head
• Nausea and vomiting
• nosebleeds
• strong shaking

In a hypertensive emergency, the symptoms are more pronounced. For example, you may experience:

• sudden chest tightness (angina pectoris)
• Breathing difficulty with rattle noise (due to water accumulation in the lungs)
• blurred vision
• numbness

Hypertensive Crisis: When to the doctor?

If there is a suspicion of a hypertensive crisis, it is important to act immediately! Only in this way can possible organ damage be prevented. As a rule, doctors monitor the patient with a hypertensive derailment first in the hospital. For the treatment blood pressure lowering agents, so-called antihypertensive agents, are used. At the same time, the doctor closely monitors whether the blood pressure drops. The aim of the treatment is to effectively lower the blood pressure to a non-critical level within 24 hours.

In case of a hypertensive emergency, the emergency doctor will take care of this on the way to the hospital. Further therapy then takes place in the intensive care unit. The patient receives the medication there via a drip, while the blood pressure values ​​are closely monitored.

Hypertensive crisis: prognosis

The prognosis for a hypertensive crisis is significantly better than for a hypertensive emergency. It is usually possible to reduce the blood pressure successfully within the required time without any damage to the organs.

In a hypertensive emergency, it is important to lower the blood pressure slowly and very controlled. The prognosis depends on whether the functioning of the organs could be restored or consequential damage (such as a stroke, kidney or eye damage) could be avoided.

In general: At the slightest suspicion of one Hypertensive crisis or a hypertensive emergency, the doctor or emergency doctor should be alerted immediately!