Yolanda has taught college Psychology and Ethics, and has a doctorate of philosophy in counselor education and supervision.
John was a 35-year-old alcoholic. His alcoholism led to several health issues, including hypertension, or high blood pressure. One Monday morning after suffering a bad hangover, John decided to abruptly quit drinking. A few hours after his last drink, John developed an intense headache. He also had a shortness of breath and his nose started to bleed. A few hours later, John became extremely anxious and shaky. Feeling concerned, he went to the emergency room. John thought that he was just going through alcohol withdrawal and was surprised when the doctor informed him that he was experiencing a hypertensive crisis.
A hypertensive crisis is a condition in which a person's blood pressure is abnormally high. Your blood pressure consists of two numbers. The systolic pressure is the number on top and measures the amount of pressure in your arteries while your heart is contracting, or beating. The number on the bottom is the diastolic pressure and measure the amount of pressure between contractions, when the heart is at rest
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A hypertensive crisis occurs when the systolic pressure is over 180 or the diastolic pressure is over 110. There are two types of hypertensive crises: hypertensive urgency and hypertensive emergency. The main difference between the two is that no organ damage occurs during hypertensive urgency. When organ damage is present, it is called a hypertensive emergency. High blood pressure puts extra stress on the arteries and blood vessels, which damages them and restricts the flow of blood to the organs. This prevents the organs from getting enough blood to function properly, which leads to organ damage. Hypertensive emergencies can be life-threatening.
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Hypertensive crises can be caused by something as simple as missing a dose of your blood pressure medicine. In John's case, it was caused by alcohol withdrawal. Stroke, heart attack, kidney trauma, and eclampsia (or pre-eclampsia) can also cause hypertensive crisis. Heart or kidney failure, cocaine abuse, and an overactive or underactive thyroid are other causes of hypertensive crisis. When combined, certain medications can also cause a hypertensive crisis.
John had several symptoms of hypertensive urgency. His head was aching, he had shortness of breath, his nose was bleeding, and he was extremely anxious.
In addition to the symptoms listed above, had John been experiencing a hypertensive emergency, his symptoms would have also included blurred vision, confusion, seizures, and chest aches. Other symptoms of a hypertensive emergency include swelling and fluid buildup, stomach problems such as nausea and vomiting, and unresponsiveness.
Treatment depends on which type of hypertensive crisis a person is in. It is important to seek medical attention quickly if your blood pressure is over 180/110 so that medical providers can determine the best method of treatment and observe whether or not organ damage has occured. In a hypertensive urgency such as John's case, reducing blood pressure can usually be done by modifying or giving an extra dose of oral medication. This does not require hospitalization. Hypertensive emergencies usually require hospitalization. Medical professionals will administer intraveneous medications to reduce blood pressure and prevent further organ damage. Additional treatment depends on what organs are affected and to what extent they are damaged.
Hypertensive crisis occurs when the blood pressure is higher than 180/110. A hypertensive urgency is when there is no organ damage present, while a hypertensive emergency occurs when there is organ damage. Symptoms of hypertensive urgency include shortness of breath, headache, and intense anxiety. Symptoms of hypertensive emergency include confusion, blurred vision, and seizures. Hypertensive crises can be treated using medication; hypertensive emergencies usually require hospitalization while hypertensive urgencies do not.
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