High blood pressure is a chronic condition, and the damage it causes to blood vessels and organs generally occurs over years.

However, it is possible for blood pressure to rise quickly and severely enough to be considered a hypertensive crisis. To reduce morbidity and mortality in this situation, early evaluation of organ function and blood pressure elevations at these levels is critical to determine the appropriate management.

Hypertensive crises can present as hypertensive urgency or as a hypertensive emergency. 

If, while monitoring your blood pressure, you get a systolic reading of 180 mm Hg or higher OR a diastolic reading of 110 mm HG or higher, wait a couple of minutes and take it again. If the reading is still at or above that level, you should seek immediate emergency medical treatment for a hypertensive crisis. If you can't access the emergency medical services (EMS), have someone drive you to the hospital right away.

Hypertensive Emergency

A hypertensive emergency exists when blood pressure reaches levels that are damaging organs. Hypertensive emergencies generally occur at blood pressure levels exceeding 180 systolic OR 120 diastolic, but can occur at even lower levels in patients whose blood pressure had not been previously high.

The consequences of uncontrolled blood pressure in this range can be severe and include

• Stroke
• Loss of consciousness
• Memory loss
• Heart attack
• Damage to the eyes and kidneys
• Loss of kidney function
• Aortic dissection
• Angina (unstable chest pain)
• Pulmonary edema (fluid backup in the lungs)
• Eclampsia