Hypertensive Crisis

Hypertensive crisis is an emergency condition which causes uncontrollable high blood pressure. This condition is also known as a hypertensive emergency, and occurs when the blood pressure increases to 180/110 mm of Hg. Around half a million Americans suffer from a hypertensive crisis at some or the other point of time. There are even cases where the blood pressure may rise to 220/140 mm of Hg, in which case there may be multiple organ damage and failure. Given below are the various causes, symptoms and treatment options for dealing with a hypertensive emergency.

Hypertensive Crisis Causes
There are many different causes that spur on a hypertensive urgency. These include:

• Abrupt discontinuation of taking hypertension medication. This is especially seen in patients that have chronic high blood pressure and who have labile hypertension.
• There are certain renal parenchymal diseases, chronic pyelonephritis, primary glomerulonephritis, etc. that may cause a sudden rise in blood pressure.
• Endocrine disorders like pheochromocytoma, Cushing's syndrome and primary hyperaldosteronism may also cause an increase in the blood pressure.
• Certain drugs like cocaine, amphetamines and cyclosporin may cause a rise in the blood pressure. Certain drug interactions, like taking monoamine oxidase inhibitors with tricyclic antidepressants, may cause a drug interaction, that could shoot up the blood pressure.
• Systemic disorders like systemic lupus erythematosus, vasculitides and systemic sclerosis may also be responsible for causing a rise in the blood pressure.
• Post-operative hypertension may also occur in the form a hypertensive crisis.
• In pregnant women, there is a medical complication known as eclampsia, where there is a sudden and uncontrollable surge in the blood pressure.

Hypertensive Crisis Symptoms
There are many tell tale signs of a hypertensive emergency. These include:

• Severe throbbing headache.
• If the blood pressure causes damage in the brain, like if there is bleeding in the brain or if there is a stroke, then it could lead to seizures and mental confusion.
• Chest pain and feeling of crushing or severe tightness in the chest. The person may also feel heart palpitations due to arrhythmia.
• Shortness of breath and difficulty in breathing.
• Swelling or edema, that is, fluid build up in the tissues may occur due to the increase in the blood flow. When this occurs in the lungs, it is known as pulmonary edema, which can be a life-threatening complication.
• There may be altered consciousness.
• Dysarthria

Hypertensive Crisis Treatment
Patients that have a blood pressure of more than 180/110 mm of Hg are at a very high risk of suffering from organ failure if not treated on a priority basis. Hence, the person will need to be admitted at a hospital, where he will need to get aggressive parenteral therapy to bring down the blood pressure immediately. However, the treatment will not only involve lowering high blood pressure, but will also involve tending to the symptoms that the patient is exhibiting. Neurologic and cardiac tests will need to be done so as to check for any kind of damage to the heart or the brain. The treatment for any abnormalities in other organs will take place only after the person's blood pressure has been stabilized. Once the blood pressure has been brought down, then the person can be switched to oral medication to maintain the blood pressure.

It is absolutely necessary to treat a hypertensive crisis on an emergency basis. This is because this condition can lead to irreversible damage to multiple organs. It can also lead to complications like stroke, blood vessel damage (which could lead to internal bleeding) and kidney shut down. Thus, to deal with this condition, one needs to immediately bring the blood pressure down so as to ensure that there is no long-lasting damage caused due to the hypertensive crisis.