What is the blood pressure in a hypertensive crisis?

Written by Li Fang Xiao
Internal Medicine
Updated on September 15, 2024
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Hypertensive crisis is a relatively urgent medical condition in clinical settings. Its diagnostic criterion is a diastolic pressure greater than 130 mmHg. Naturally, the higher the blood pressure, the greater the threat. A hypertensive crisis can lead to many clinical symptoms, such as acute left heart failure, dizziness, headache, cerebral hemorrhage, and acute renal failure. The most common causes of hypertensive crisis are primary or secondary hypertension, which, under certain specific circumstances, lead to uncontrollably high blood pressure and related clinical symptoms. The focus of treatment is on controlling the blood pressure and choosing different treatment plans for complications. For instance, in the case of heart failure, vasodilators and diuretics may be used for symptomatic treatment.

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Difference between hypertensive crisis and hypertensive encephalopathy

Hypertensive crisis, now referred to as hypertensive emergency, includes hypertensive encephalopathy. It mainly refers to cases where, under certain triggers, the blood pressure of patients with primary or secondary hypertension suddenly or significantly rises, typically exceeding 180/120 mmHg, accompanied by progressive failure of critical target organs such as the heart, brain, and kidneys. Hypertensive emergencies include hypertensive encephalopathy, cerebral hemorrhage, cerebral infarction, acute heart failure, acute coronary syndrome, aortic dissection, etc. Hypertensive encephalopathy is characterized by symptoms caused by hypertension, such as headache, blurred vision, nausea, vomiting, and severe edema of the head.

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What is hypertension?

Hypertension is characterized by elevated arterial blood pressure in the systemic circulation, and may be accompanied by functional or organic damage to organs such as the heart, brain, and kidneys. Hypertension can be divided into primary hypertension and secondary hypertension. Secondary hypertension is due to certain identified causes or etiologies, leading to increased blood pressure, accounting for about 5% of all hypertension cases. Conditions like primary aldosteronism, pheochromocytoma, renovascular hypertension, and renin-secreting tumors are examples, and cases where the cause of increased blood pressure cannot be found are also referred to as primary hypertension and hypertensive disease. Currently, the classification and standard for blood pressure in China mostly use a systolic pressure of greater than or equal to 140 mmHg and/or a diastolic pressure of greater than or equal to 90 mmHg.

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Causes of pregnancy-induced hypertension

There are many reasons that can lead to the occurrence of hypertensive disorders during pregnancy. Normally, due to reasons related to the mother herself or being under the age of 18 or over 35, the risk of developing hypertensive disorders during pregnancy may increase. Additionally, dietary and environmental influences such as a high-salt diet, excessive fatigue, and mental stress can lead to the development of pregnancy-induced hypertension. In some cases, after the development of pregnancy-induced hypertension, it may trigger diseases in other organ systems, leading to severe issues with the placenta, causing complications such as placental abruption, hypoalbuminemia, and cerebrovascular accidents.

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What is the general blood pressure for hypertensive nephropathy?

Hypertension caused by kidney disease is called renal hypertension. The blood pressure of patients with renal hypertension is generally higher than that of those with primary hypertension. However, these patients can exhibit any range of blood pressure types. Their blood pressure might be in stage 1, meaning the systolic pressure is between 140 to 160 mmHg. It could also reach stage 3, where the systolic pressure exceeds 180 mmHg. In cases of heart failure, the patient's blood pressure might even reach 220 or 240 mmHg, though such extreme cases are relatively rare.

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What to eat for high blood pressure

Patients with hypertension need to regularly take antihypertensive medication to bring their blood pressure within the normal range. In daily life, dietary adjustments should be made, avoiding foods high in fats such as fatty meat from animals, offal, fried foods, and sweets. Instead, consume more vegetables high in dietary fiber, vitamins, and trace minerals. Suitable vegetables for people with hypertension include celery, spinach, mung bean sprouts, black fungus, water chestnuts, onions, carrots, winter melon, and Chinese cabbage.