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Heart Health Understanding the Heart

Hypertension Q & A


Author:

Jacqueline Suk, MD

Brigham and Women's Hospital

Medically Reviewed On: March 31, 2006

How can I tell if my blood pressure is high enough to warrant a trip to the emergency room?
In general, if you have high blood pressure, you should be seeing a doctor regularly to keep your blood pressure under control. A normal blood pressure can range from 100 to 140 mmHg, systolic (the top number of a blood pressure reading) and 50 to 90 mmHg diastolic (the bottom number of a blood pressure reading).

If you have had high blood pressure for a long time, for example, 180/100, your body may have become used to these high pressures, although it may be silently working its damage over the years on vital organs such as your brain, heart, and kidneys. If you know you have high blood pressure, you should be working with a doctor to bring your blood pressure down gradually.

There are situations, however, when your blood pressure can shoot up suddenly, called malignant hypertension. This can occur silently and without symptoms, causing silent damage to your body. Fortunately, malignant hypertension is sometimes accompanied by symptoms such as headaches, visual changes such as blurriness, lightheadedness, dizziness, sweating, nausea, or chest pain. In any situation where you feel the severe and sudden onset of these symptoms, it would be prudent to seek medical attention. For one, if it is severe hypertension, there are effective medications that can be administered to you to bring your blood pressure to within safe range. For another, these can also be the presenting symptoms of a heart attack; and time is of the essence in the proper diagnosis and management of such acute coronary syndromes.

If you know that you have hypertension and you and your doctor are in the process of finding the right combination of medications to bring your blood pressure under control, a practical thing to do is to obtain a home blood pressure monitor. There are several varieties of differing qualities available in local drug stores. They become useful when you test it for accuracy against the blood pressure reading that your doctor obtains in the office. Even accounting for slight variations in quality, it can then help you to monitor your blood pressure at home, and allow you to participate actively in monitoring your blood pressure, and assessing when there are severe swings of blood pressure about which you should contact a health professional.

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