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.
At what BP level should you go to the ER?
“The American Heart Association states that a reading of 180/110 or greater requires immediate medical attention. If you take this reading two times in a row, five minutes apart, then you must head to the nearest ER,” says Dr. Meier.
What to do when suddenly BP gets high?
Do not wait until your blood pressure comes down on its own. Get help right away. Call your doctor or nurse call line now or seek immediate medical care if: Your blood pressure is much higher than normal (such as 180/110 or higher), but you don't have symptoms.
A hypertensive (high blood pressure or HBP) crisis is when blood pressure rises quickly and severely with readings of 180/120 or greater.
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
An elevated reading may or may not be accompanied by one or more of the following symptoms:
Severe headache
Shortness of breath
Nosebleeds
Severe anxiety
Know the two types of high blood pressure crisis to watch for
There are two types of hypertensive crises—both require immediate attention as early evaluation of organ function is critical to determine an appropriate course of action.
Hypertensive Urgency
If your blood pressure is 180/120 or greater, wait about five minutes and try again. If the second reading is just as high and you are not experiencing any other associated symptoms of target organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, or difficulty speaking, this would be considered a hypertensive urgency. Your healthcare provider may just have you adjust or add medications, but rarely requires hospitalization.
Hypertensive Emergency
If your blood pressure reading is 180/120 or greater and you are experiencing any other associated symptoms of target organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, or difficulty speaking then this would be considered a hypertensive emergency. Do not wait to see if your pressure comes down on its own, Call 911.
Be prepared
If you have been diagnosed with high blood pressure, track your blood pressure and medications. If possible during an emergency, having these logs with you can provide valuable information to the medical team providing treatment.
How does ER treat high BP?
Vasodilators such as nitroprusside and nitroglycerin are also used to treat a hypertensive emergency. The goal of therapy for a hypertensive emergency is to lower the mean arterial pressure by no more than 25% within minutes to 1 hour and then stabilize BP at 160/100-110 mm Hg within the next 2 to 6 hours.
