Should you call 911 or your doctor for high blood pressure? Knowing what to do and when to do it is very important, especially if you have a high blood pressure emergency or urgency. Not trying to scare you, but high blood pressure (hypertension) emergency or urgency are serious. Both are associated with serious illness and possible death.
Nevertheless, there is some caution to consider to avoid lowering your blood pressure down too fast. Doing this could decrease blood flow to vital organs (i.e., eyes, heart, kidney, and liver).
You should always ask your health care provider for advice about when to contact 911 versus your doctor’s office. That said, generally, where to call depends on several factors. Some major factors to consider are your health history, blood pressure severity, and associated symptoms.
Blood Pressure Severity
Everybody is different and blood pressure severity may be different for different age groups, and people with comorbidities. For the general public, 160/110 mm Hg is considered severe according to the current hypertension guidelines. Your job is to ask your doctor what is considered severe for you and specific actions to take. You want to know this so you will be prepared to take action quickly to minimize worry and confusion.
Health History
People with heart disease (i.e., coronary heart disease, ischemic heart disease, congestive heart disease, peripheral vascular disease, stroke, transient ischemic attack-TIA, or others) or who have blood pressures as high as 180/120 mmHg or more without symptoms should call their primary care doctor but if they have any symptoms associated with the elevation, they should call 911.
Associated Symptoms
Rapidly reducing blood pressure in the emergency room has not been widely researched in large randomized clinical trials. Yet, emergency room providers rapidly reduce blood pressure according to their professional experience. Most of them use rapid treatment in high blood pressure emergency (abrupt severe high blood pressure with life-threatening organ damage) versus urgency (abrupt severe high blood pressure without symptoms of organ damage).
Always call 911 for any blood pressure associated with symptoms. These symptoms include chest pain, shortness of breath, or stroke symptoms. Face drooping, arm weakness, speech difficulty, vision loss, severe headache, dizziness or loss of consciousness are stroke symptoms.
https://www.youtube.com/watch?v=9URuCvEyeCU
Get An Accurate Blood Pressure Measurement
You need a validated arm cuff home blood pressure monitor to determine if your blood pressure is elevated. Use the correct size arm cuff and a correct measurement technique to assure accuracy.
For the average adult, the 2017 blood pressure guidelines recommend specific step-by-step instructions for blood pressure measurement.
1). Empty your bladder
2). No smoking, coffee, or eating for 30 minutes prior to measuring
3). Place the cuff on bare arm, be seated in the appropriate position, and wait at least 5 minutes before measuring. See the link below for the complete 2017 hypertension guidelines.
https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2017/11/09/11/41/2017-guideline-for-high-blood-pressure-in-adults
How Frequent Should You Take Your Blood Pressure
Take your blood pressure in both arms and if there is no significant difference between your right and left arm (less than 10 mm Hg) you may take your blood pressure in either arm when measuring. If your blood pressure is 10 mm Hg or more between your two arms, notify your health care provider. The best practice is to routinely take your blood pressure in the arm with the highest reading for your true blood pressure.
You also need to monitor your blood pressure every morning and every night until your blood pressure is at your target goal. Then, monitor your blood pressure at least once a week morning and evening, and at least 3-7 days morning and evenings before going to your doctor’s office.
When to Call Your Health Care Provider?
Call your health care provider’s office for an appointment if your blood pressure is consistently elevated. Elevated blood pressure may be different for different people and populations and well as the location or method of the measurement.
According to the new hypertension guidelines released in 2017, blood pressure is high for the average person without cardiovascular risk factors if the office blood pressure is 140/90 mm Hg or more. Blood pressure is high for the average person without cardiovascular risk factors if the home blood pressure is 135/90 mm Hg or more. Moderately high blood pressure is considered to be 160/110 mmHg, but if you have no associated symptoms, contact your health care provider for management. Chest pain or shortness of breath could cause harm; therefore, you should call 911 for these and other associated symptoms.
Unless otherwise indicated by your doctor, asymptomatic elevated home blood pressure measurements should be repeated to confirm elevation or confirmed by the emergency medical team (EMS) or your local fire department.
Before You Make the Call to Your Health Care Provider
Before you make the call to your health care provider office, gather your blood pressure measurements, an exact list of your medications, and your pharmacy’s phone number as a quick reference. Many times blood pressure needs to be monitored very closely to determine if your prescription needs to be adjusted. Nevertheless, do not hesitate to overreact, as recommended by the American Heart Association for stroke symptoms.
When to Go to the Emergency Room?
Again, it is best to check with your healthcare provider to determine what to do. Generally, you need to go to the emergency room if it is after office hours or the weekend, you HAVE TAKEN YOUR MEDICATION, and your blood pressure is severe such as 180/120 mm Hg or more (even if you are not having any symptoms).
When to Call 911?
https://www.youtube.com/watch?v=uOWYcKaDnUg
Call 911 anytime you are having stroke-like symptoms such as blurred vision, trouble seeing out one or both eyes, headache on one side of your head, facial weakness or drooping, weakness or numbness on one side of the body or in one arm or leg, trouble swallowing, falling down, unable to walk, trouble understanding simple commands or other symptoms no matter what your blood pressure is.
A blood pressure of 140/90 mmHg or greater with associated symptoms such as a sudden severe headache, nausea, vomiting, or loss of consciousness is potentially life-threatening. So be sure to call 911 for high blood pressure with associated symptoms.
Be sure to call a family member, friend, or neighbor for help if you are alone at home, and remember to call your health care provider for a follow-up appointment after visiting the emergency room.
Resource
Muiesan, M. L., Salvetti, M., Amadoro, V., di Somma, S., Perlini, S., & Semplicini, A…Pedrinelli, R. (2015). An update on hypertension emergencies and urgencies. Journal of Cardiovascular Medicine, 16(5), 372-382.
Salvetti, M., Paini, A., Bertacchini, F., Stassaldi, D., Aggiusti, D., Rosei, C. A…Muiesan, M. L. (2018). Acute blood pressure elevation: Therapeutic approach.Pharmacoogical Research, 130, 180-190.
Paini, A. (2018). High Blood Pressure Cardiovascular Prevention Definitions and Epidemiological aspects of hypertensive urgencies and emergencies.
