When Shall I Go To ER for High Blood Pressure?

If you have been diagnosed with hypertension (high blood pressure), it is essential and beneficial to regularly monitor your blood pressure at home.

What shall I do if my blood pressure is high?

Blood pressure fluctuates throughout the day and varies depending on our activities, mood, diet and medication. For a young and healthy individual, blood pressure no higher than 120/80 mmHg is considered normal (1).

However, if you have been diagnosed with hypertension, your doctor most likely have given you a range, instead of a single number, as recommended blood pressure levels for you to follow.

An appropriate range recommended by our doctor differs for each person, depending on our age, overall health, other medical conditions we might have, and medications we are taking. There are always two numbers in a blood pressure reading. I explained what each number means in this article. It is important to keep a journal of your home blood pressure, and know the range of your baseline blood pressure.

If you saw a blood pressure that is higher than usual and you have any symptoms, such as headache, dizziness, blurred vision or difficult in speech, you should call your doctor right away. If you are not feeling any discomfort and your blood pressure is below 180/120 mmHg, then it is best to recheck your blood pressure.

Before you repeat the measurement, look for possible causes and fix them:

Did you forget to take your regular medications?

Did you just have coffee or soda?

Did you consume high-salt food lately?

Were you running around right before your took the measurement?

Did you just have a heated debate with someone?

After ruling out all possible causes for high blood pressure, sit down in a quiet room and rest for 5 minutes before you repeat the measurement. When you get the new reading, write it down into your journal and compare it to your previous record.

If your second blood pressure reading falls into your normal range, great. If the high blood pressure persists, it is time to call your doctor.

If you have been prescribed blood pressure medicine by your doctor but you forget to take them, take your medication now. Adherence to medication is critical for optimal blood pressure control.

When shall I go to ER for high blood pressure?

If your blood pressure is ≥ 180 mmHg in the first number and/or ≥ 120 mmHg in the second number, you should call your doctor or go to emergency room right away.

Blood pressure ≥ 180/120 mmHg is called hypertension urgency (2). Damages can occur to your brain, kidney and many other organs with life-threatening consequences such as strokes and acute kidney injury. When such organ damages occur, it is called hypertension emergency. In both hypertension urgency and emergency, you should seek immediate medical treatment.

During hypertension urgency and emergency, you might be noticing some of the warning signs already, such as headache, blurred vision, weakness, nausea and vomit, or slurred speech. However, hypertension is a notorious silent killer, and people may be suffering from life-threatening conditions without any signs. In addition, hypertension urgency often occurs due to second causes including tumors that secret hormones and need to be properly treated (3). Therefore it is critical not to neglect the high blood pressure reading, and take proper actions immediately.

References

  1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018;71(6):e13–115.
  2. Martin JFV, Higashiama E, Garcia E, Luizon MR, Cipullo JP. Hypertensive crisis profile. Prevalence and clinical presentation. Arq Bras Cardiol 2004;83(2):131–6; 125–30.
  3. Padilla Ramos A, Varon J. Current and newer agents for hypertensive emergencies. Curr Hypertens Rep 2014;16(7):450.

About the Author Isabel Wang, MD/PhD

I received my MD from PUMC in Beijing China and my Ph.D. in Biochemistry from Stony Brook University on Long Island. Over the years, I have worked in the fields of genetic research and clinical medicine in different parts of the US, including PA, MO, CT, FL, NY and MI. My research has been published in multiple scientific journals. Currently I live in Ann Arbor, MI with my husband and our children and Mango the orange tabby. I love hiking, running, baking, cooking and biking.

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