What is Severe Hypertension?

High blood pressure is categorized in one of three ways: hypertension, severe hypertension and hypertensive crisis. Severe hypertension, also known as stage two hypertension, is one of the most common cardiovascular diseases and occurs when the heart pumps more blood than can easily flow through the arteries, which increases blood pressure and can damage the arteries. When left untreated, it is the leading cause of strokes and one of the primary causes of heart attacks.

Blood pressure is measured by systolic pressure and diastolic pressure. Systolic pressure is the pressure — measured in millimeters of mercury (mm Hg) the arteries endure while the heart fills them with blood, and diastolic pressure is the amount of pressure the arteries are under when the heart is resting. A healthy adult has a blood pressure reading either at or below 120 millimeters of mercury systolic over 80 mm Hg diastolic. An adult with severe hypertension has a blood pressure reading above 160 over 100, with anything above 180 over 120 being considered a hypertensive crisis.


Hypertension typically does not have any recognizable symptoms and usually is diagnosed only during routine check-ups, but severe headaches, anxiety, trouble sleeping and shortness of breath often accompany severe hypertension. Dizzy spells and a larger-than-normal amount of nosebleeds also can be side effects of hypertension. Blood pressure typically rises with age, resulting in almost every person having high blood pressure at some point in his or her life, but those at risk for severe hypertension include people with a family history of high blood pressure, those who are overweight or obese. A lack of physical activity, tobacco use, excessive alcohol intake, excessive sodium intake, a lack of potassium, a lack of vitamin D, extreme stress and chronic conditions such as high cholesterol, kidney disease and diabetes also can contribute to severe hypertension.

Treatment of severe hypertension usually is a combination of drugs and lifestyle changes. Those experiencing severe hypertension are urged not only to eat healthier, quit smoking if they smoke, lose weight and reduce their salt intake, and they typically are prescribed one or more medications to control their blood pressure. These can include a combination of any of the following: thiazide diuretics, beta blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, rennin inhibitors, alpha blockers, alpha-beta blockers, central-acting agents and vasodilators. After blood pressure is under control, doctors also might recommend that the patient take a low dose of aspirin every day to protect his or her heart from cardiovascular disorders.

A diagnosis of severe hypertension usually results in a patient taking medication for the rest of his or her life. Possible complications of this condition include stroke, aneurysms, heart failure, metabolic syndrome, renal failure and heart attacks. The control of hypertension, however, greatly reduces the risk of any future complications.



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