Hypertensive Crisis – You’re CALLING 911 Or A Doctor!

Hypertensive crisis is the most serious of the five BP categories. If your BP ever reaches hypertensive crisis, you’re going to do one of two things, call a doctor or 911. It depends on your symptoms and knowing which call to make is crucial. What is considered a hypertensive crisis?

Hypertensive crisis is when blood pressure rises quickly and severely. The BP range for hypertensive crisis is systolic blood pressure higher than 180 mmHg and/or diastolic blood pressure higher than 120 mmHg. Hypertensive crisis pressure combined with symptoms requires urgent medical attention.

I’ve dug down deep on this topic and will let you know everything you need about hypertensive crisis. It’s crucial to know about this BP category because the consequences can be fatal or drastically affect your life. In addition, I’ll discuss how to know whether to call a doctor or 911.

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What is Hypertensive Crisis?

Hypertensive crisis is when blood pressure increases quickly to a systolic blood pressure more than 180 mmHg and/or a diastolic blood pressure more than 120 mmHg. Hypertensive crisis without symptoms requires a notification to a physician. Hypertensive crisis with symptoms requires immediate medical attention.

The AND/OR between the systolic and diastolic numbers is extremely important. This means for blood pressure to be in hypertensive crisis only one of the two numbers have to be higher and not both of them 1.

Let’s go over a few examples to explain it more clearly.

Blood pressure 170/130

Even though the systolic number is 180 or less, it’s hypertensive crisis because the diastolic number is higher than 120.

Blood pressure 190/124

This is hypertensive crisis because systolic is more than 180 and diastolic is more than 120.

Blood pressure 190/110

This is hypertensive crisis because the systolic number is higher than 180 even though the diastolic number is less than 120.

Signs Of Hypertensive Crisis

It’s possible blood pressure numbers are high enough to be in this range and a person is unaware. Sometimes there may be signs informing you there might be trouble 2. What are signs of hypertensive crisis?

Signs of hypertensive crisis may include the following:

  • Severe headache
  • Shortness of breath
  • Nosebleed
  • Severe anxiety

Hypertensive Crisis Guidelines

If you think blood pressure has suddenly increased severely, what are the guidelines for hypertensive crisis?

The following are guidelines for hypertensive crisis:

  • If systolic or diastolic blood pressure is higher than 180/120 mmHg, wait about 5 minutes and take it again.
  • If the 2nd measurement is just as high and the following symptoms are not present:
    • Chest pain
    • Shortness of breath
    • Back pain
    • Numbness or weakness
    • Change in vision
    • Difficulty breathing
  • Call a physician immediately and be guided by their advice. This is a hypertensive urgency.
  • If any of the symptoms above exist, call 911 immediately. This is a hypertensive emergency.

A hypertensive urgency rarely requires hospitalization. A healthcare provider may have the patient adjust or add medications.

Hypertensive Crisis Consequences

If you ever find yourself with uncontrolled blood pressure and the symptoms noted above, the consequences can be severe 3. The importance of calling 911 or a doctor cannot be stated enough.

The phone call for medical assistance cannot be delayed hoping the blood pressure will go down, the risk is too high. What are the consequences of hypertensive crisis?

The following are 10 consequences of hypertensive crisis:

  1. Stroke: The blood supply to the brain is interrupted.
  2. Loss of consciousness: A fainting episode.
  3. Memory loss: Trouble recalling information or events.
  4. Heart attack: When the flow of blood to the heart is blocked.
  5. Damage to the eyes & kidneys: The blood vessels in the eye retina can suffer damage.
  6. Loss of kidney function: The arteries around the kidneys can suffer damage and fail to deliver blood.
  7. Aortic dissection: The aorta artery develops a tear in the wall. This can cause a decrease in blood to the body’s organs or a rupture of the aorta.
  8. Angina: The heart experiences a reduction in blood flow causing a severe pain in the chest. The pain might spread to the neck, shoulders or arms.
  9. Pulmonary edema:This is when fluid builds up in the air spaces and tissues of the lungs. This can cause cardiac arrest or fatal respiratory distress.
  10. Eclampsia: A condition that can cause a coma or seizures with pregnant women.

Hypertensive Crisis & The Blood Pressure Chart

There are five blood pressure categories in the blood pressure chart. Hypertensive crisis is the 5th one and the most severe.

Each category has distinctive names and numbers for the two types of blood pressures, systolic and diastolic. The blood pressure numbers determine what blood pressure category the measurement falls into.

It’s significant to note the words and/or between the systolic and diastolic numbers. It makes an important difference whether both numbers or just one of the numbers classify the BP range. For hypertensive crisis (and/or) it can be both numbers or just one of them. The categories on the BP chart from least serious to serious are:

  1. Normal
  2. Elevated
  3. High Blood Pressure Stage 1
  4. High Blood Pressure Stage 2
  5. Hypertensive Crisis

I wrote an article on just the BP chart. Check it out and learn more about it and the other categories. In addition, I have a BP chart which you can print out near the end of the article, What Is The Blood Pressure Chart?

Hypertensive Crisis Risk Factors

High blood pressure is often called the “silent killer” because people don’t typically know they have it. Certain physical traits and lifestyle choices can increase the risk for high blood pressure or hypertensive crisis 4. What are hypertensive risk factors?

The following are five common hereditary and physical risk factors for high blood pressure:

  1. Age: People are more likely to get high blood pressure as they get older. When a person gets older, the blood vessels gradually lose some of their elasticity. The hardened blood vessels contribute to increased blood pressure.
  2. Family History: If parents or other close relatives have high blood pressure, there’s an increased risk.
  3. Gender: Up to age 64, men are more likely to get high blood pressure than women are. At age 65 and older, women are more likely to get high blood pressure.
  4. Race: African-Americans are more likely to develop high blood pressure than any other racial background in the United States.
  5. Chronic Kidney Disease: High blood pressure may occur as a result of kidney disease. In addition, having HBP may cause further kidney damage.

The following are eight modifiable risk factors for high blood pressure:

  1. Unhealthy Diet
  2. Lack of physical activity
  3. Being Overweight or Obese
  4. Excess Alcohol
  5. High Cholesterol
  6. Smoking and Tobacco
  7. Lack Of Sleep and Sleep Apnea
  8. Stress

Hypertensive Crisis Treatment


It is likely the doctor will prescribe blood pressure medicine after having BP high enough to be in the hypertensive category. It’s possible if you’re already on medication, the doctor may change it, alter the dose or add a combination of medicines 5.

The following is the common blood medications prescribed for BP as high as hypertensive crisis:

  • Alpha blockers: Helps ease blood flow by relaxing the artery walls.
  • Ace inhibitors: Helps ease blood flow by expanding the blood vessels.
  • Beta-blockers: Lessen the amount of blood being pumped by reducing the heart rate.
  • Diuretics: Help the body get rid of excess fluids and sodium.
  • Calcium channel blockers: They expand the arteries and slow down the heart rate.
  • Alpha-2 receptor agonists: Helps to lower blood pressure by decreasing the nervous system activity.
  • Angiotensin ll receptor blockers: They block the effects of angiotensin, a protein in the blood that causes the blood vessels to constrict.

Lifestyle Changes

In addition to medication, the doctor will recommend lifestyle changes. The changes can have an enormous affect on the blood pressure levels. Once the blood pressure is under control these changes should become a way of life.


Eat foods high in magnesium. Magnesium has a calming affect on the body and the blood vessels. They allow the blood vessels to open and stay unconstricted. In addition, magnesium can help improve sleep and stay more relaxed 6.

The following are 5 foods high in magnesium:

  1. Spinach
  2. Pumpkin seeds
  3. Swiss chard
  4. Dark chocolate
  5. Almonds

In addition to magnesium, another way to help prevent hypertensive crisis is with foods high in potassium. Potassium helps the kidneys balance the fluid in the body. Numerous studies (resource) have shown an association between low potassium levels and high blood pressure 7.

Foods high in potassium include:

  • Sweet potato
  • Avocado
  • Lima beans
  • Swiss chard
  • Acorn squash
  • Spinach

The problem with daily nutrition is the high amount of sodium consumed. While sodium is important and needed, most people get 3 to 4 times the amount they should be consuming.

If you’re not sweating all day long at work or a highly trained athlete, the American Heart Association recommends approximately 1,250-1,500 mg of sodium a day.

Avoid the following foods high in saturated fats:

  • Fatty red meats
  • Pork
  • Chicken skin
  • Fried food
  • Lamb
  • Sausages
  • Hot dogs.

Instead eat skinless chicken, organic lean grass fed beef, salmon and halibut.

Avoid foods with added sugars like donuts, pastries, deserts, ice cream, cakes, cookies and candy. There’s strong evidence that sugar can raise blood sugar and insulin levels. This causes an increase in the heart rate and BP because it activates the sympathetic nervous system.

Physical Activity

Physical activity is one of the best ways to improve health and help lower BP. Enjoy about 20-30 minutes of some form of physical activity. You don’t have to join or go to a gym, unless you want to. There are many easy ways to get the activity needed. Here are some ideas for you.

  • Walking
  • Jogging
  • Yoga
  • Cardio exercise

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Related Questions

What is some emergency treatment for high blood pressure at home? Emergency treatment for high blood pressure includes the following:

  • Call 911 and be guided by their advice.
  • Don’t panic and stay calm.
  • Sit or lay down.
  • Regulate breathing with slow, deep breaths.
  • Keep the room temperature comfortable.

What is the difference between hypertensive crisis and hypertensive emergency? Hypertensive crisis is when blood pressure rises quickly and systolic BP is more than 180 mmHg and/or a diastolic BP is more than 120 mmHg. A hypertensive emergency is hypertensive crisis BP numbers with the following symptoms: chest pain, change in vision, shortness of breath, difficulty breathing, back pain, numbness or weakness.

How does hypertensive emergency cause organ damage? Hypertensive emergency causes organ damage when the blood vessels suffer damage and fail to deliver blood to the organs. The lack of blood to the organs causes damage.

Read Next – More BP Category Articles!

High Blood Pressure Stage 1 – The 1st High BP Range

High Blood Pressure Stage 2 – The MORE SERIOUS High BP Range

Normal Blood Pressure – Surprisingly It’s Not 120 Over 80

The Elevated Blood Pressure Range

High Diastolic Blood Pressure Meaning

Article Resources: Blood Pressure Explained follows strict guidelines to ensure our content is the highest journalistic standard. It's our mission to provide the reader with accurate, honest and unbiased guidance. Our content relies on medical associations, research institutions, government agencies and study resources. Learn more by reading our editorial policy.
  1. American Heart Association: Hypertensive Crisis: When You Should Call 911 for High Blood Pressure[]
  2. National Center for Biotechnology Information: Hypertensive Emergency[]
  3. National Center for Biotechnology Information: Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature[]
  4. CDC: High Blood Pressure[]
  5. American Heart Association: Types of Blood Pressure Medications[]
  6. Hypertension: Effects of Magnesium Supplementation on Blood Pressure[]
  7. Harvard Health: Potassium lowers blood pressure[]

Kevin Garce

Kevin Garce is a Certified Health Coach who encourages people by informing them on blood pressure topics important to them. His years of research and knowledge inspire people to achieve their goals. Read more here About Me

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