Hypertensive crisis
and Martina Feichter, medical editor and biologistMartina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
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Doctors describe a sudden, massive increase in blood pressure as a hypertensive crisis. Terms such as hypertensive derailment, hypertonic crisis, high pressure crisis or blood pressure crisis are synonyms for this phenomenon. A hypertensive crisis is a life-threatening condition and requires immediate medical attention. Read more about warning signs and treatment for hypertensive crisis.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. O14I10I11O13I15I13
What is a hypertensive crisis?
In a hypertensive crisis, the blood pressure rises very quickly to critical values. These exceed 230 mmHg (i.e. millimeters Hg) for systolic pressure and 130 mmHg for diastolic blood pressure. Normally, healthy blood pressure is around 120 to 80 mmHg.
Doctors differentiate between the terms hypertensive crisis and hypertensive emergency. In the hypertensive crisis, the blood pressure is threateningly high, but there are no symptoms that indicate damage to organs. In contrast to this, in a hypertensive emergency there is a mortal danger because organ damage has already occurred. A hypertensive crisis can quickly turn into a hypertensive emergency, especially if not treated in a timely manner.
Hypertensive crisis: causes
A hypertensive crisis can have many causes. It usually occurs in connection with an existing high blood pressure (primary or secondary arterial hypertension), sometimes in connection with the sudden discontinuation of the antihypertensive drugs.
A hypertensive crisis is rarely seen in people who otherwise have normal blood pressure. Then, for example, acute inflammation of the kidney corpuscles (acute glomerulonephritis) or eclampsia can be the cause. In the case of certain diseases of hormone-producing organs, a large amount of blood pressure-effective messenger substances can suddenly be released, which can cause blood pressure to rise to dangerous levels within minutes. This can happen with pheochromocytoma (a tumor of the adrenal medulla).
Less often, alcohol withdrawal or drug abuse (cocaine, amphetamines) lead to a blood pressure crisis.
Hypertensive crisis: signs
A hypertensive crisis does not always cause clear symptoms. Especially in people who have had high blood pressure for some time, the symptoms are often uncharacteristic. The following symptoms can indicate a hypertensive derailment:
- Red head
- Headache or extreme pressure in the head
- Nausea and vomiting
- Nosebleeds
- severe tremor
In a hypertensive emergency, the symptoms are more evident. For example:
- sudden tightness in the chest (angina pectoris)
- Difficulty breathing with rattling noises (caused by accumulation of water in the lungs)
- Visual disturbances
- Numbness
Hypertensive crisis: when to see a doctor?
If a hypertensive crisis is suspected, action must be taken immediately! This is the only way to prevent possible organ damage. As a rule, doctors first monitor the patient with hypertensive derailment in the hospital. Antihypertensive drugs are used for treatment. At the same time, the doctor closely checks whether the blood pressure is falling. The aim of the treatment is to effectively lower blood pressure to a non-critical level within 24 hours.
In the event of a hypertensive emergency, the emergency doctor takes care of this on the way to the hospital. Further therapy then takes place in the intensive care unit. There, the patient receives the medication 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. In most cases, it is possible to successfully lower blood pressure with medication within the required time without damage to organs.
In a hypertensive emergency, it is important to lower blood pressure slowly and in a very controlled manner. The prognosis depends on whether the functioning of the organs has been restored or whether consequential damage (such as a stroke, kidney or eye damage) has been avoided.
In general, the following applies: If there is the slightest suspicion of a hypertensive crisis or a hypertensive emergency, the doctor or emergency doctor should be alerted immediately!
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