Hypertensive Crisis: Blood Pressure 180/120 mm Hg

High blood pressure usually doesn't produce immediate symptoms or damage your body. But if you suffer from high BP, at times, it can rise to very high levels, causing a crisis that may cause damage to your organs.

During this time, seeking immediate medical attention and controlling BP is essential. Hence, if you suffer from high blood pressure, you must be aware of the normal range of blood pressure, when it becomes too high, what you should do in that situation, and how to prevent it.

Doctor checking BP
Image from Freepik

What are the Ranges of Blood Pressure?

Here are the ranges of blood pressure-

  1. Normal BP: When the blood pressure reading is less than 120/80 mm Hg, it is considered normal.
  2. Elevated BP: If the blood pressure consistently ranges from 120-129 mm Hg systolic and lower than 80 mm Hg diastolic, it is considered elevated.
  3. Hypertension Stage 1: When the blood pressure readings consistently range from 130-139 mm Hg systolic and 80-89 mm Hg diastolic, it is stage 1 hypertension.
  4. Hypertension Stage 2: When the blood pressure consistently ranges above 140/80 mm Hg, it is considered stage 2 hypertension.

What is a Hypertensive Crisis?

It is a hypertension stage in which your blood pressure becomes very high, exceeding 180/120 mm Hg. During a hypertensive crisis, you may feel the following symptoms-

  • A bleeding nose
  • Intense headache
  • Severe anxiety
  • Breathing difficulties

If the blood pressure during a hypertensive crisis is not controlled, it can lead to:

  • Stroke
  • Loss of memory
  • Unconsciousness
  • Eye and kidney damage
  • Dysfunction of the kidneys
  • Eclampsia (convulsions in pregnant women due to high blood pressure)
  • Heart attack
  • Aortic Dissection (rupture of the inner layer of the body's primary artery, the Aorta)
  • Pulmonary edema (fluid backup in the lungs)
  • Unstable chest pain

The hypertensive crisis is of 2 types, i.e., hypertensive urgency and hypertensive emergency.

Hypertensive Urgency vs. Emergency:

Suppose your blood pressure reading is 180/120 mm Hg or greater. You are not experiencing any symptoms of organ damage, like shortness of breath, chest pain, back pain, change in vision, numbness/weakness, or difficulty speaking. In that case, you should retake a reading after 5 mins.

If the second reading is just as high as the first one, it is considered a hypertensive urgency. In this situation, you must consult your doctor as they may have to adjust or add to your medication, but this condition rarely requires hospitalization.

On the other hand, if your blood pressure is above 180/120 mmHg and you are experiencing the symptoms of end-organ damage mentioned above, you are going through a hypertensive emergency. In this situation, you should not wait to see if your BP goes down on its own. Instead, you should call an ambulance and immediately seek medical attention.

An old man having a hypertensive crisis
Image from Freepik

Hypertensive Crisis: Causes

Some of the most common causes of hypertensive crisis in high BP patients are as follows-

  • Non-compliance with medication
  • Older age
  • Intoxication by stimulants like cocaine, methamphetamine, and phencyclidine
  • Withdrawal from clonidine, beta-adrenergic blockers (medications)
  • Physiological stress
  • Adverse drug interactions

What Should You Do During a Hypertensive Crisis?

You should immediately call an ambulance and seek immediate medical attention. This is not a condition that you should try to manage by yourself.

How to Prevent a Hypertensive Crisis?

Taking your medication on time is the most effective action to prevent a hypertensive crisis. Because people who do not take their blood pressure medications on time are more likely to get hospitalized for heart problems.

Along with taking medications, you can make specific lifestyle changes that help keep your BP in control.

  • Implement a DASH (Dietary Approaches to Stop Hypertension) diet.
  • Do not drink alcohol. However, if you do, drink in moderation, i.e., less than two drinks/ day for men and less than one drink/ day for women.
  • During a week, perform at least 150 mins of medium-intensity aerobic activity or 75 minutes of vigorous aerobic exercise.
  • Avoid smoking or second-hand smoke.
  • Get at least 7 to 8 hours of daily sleep.


A hypertensive crisis is a severe condition that can become deadly if not treated immediately. Hence, if you have hypertension, always watch for these symptoms.

If you think you are having a hypertensive emergency, do not hesitate to seek help immediately. And even if it is a hypertensive urgency, consult your doctor as soon as possible.

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