What causes a hypertensive emergency?

A hypertensive emergency can occur in people with a history of high blood pressure, particularly those with a blood pressure reading of 140/90 mm Hg or higher. It is also more common in African-Americans, males, and smokers. Health conditions that increase the risk of a hypertensive emergency include kidney disorders or failure, drug use (e.g., cocaine, amphetamines, birth control pills, monoamine oxidase inhibitors), pregnancy, autoimmune diseases, spinal cord injuries, renal stenosis, aortic narrowing, and not taking prescribed high blood pressure medication.

Diagnosis of a hypertensive emergency involves a review of medical history, blood pressure measurement, and assessment of symptoms such as changes in vision, chest pain, or shortness of breath. Tests may be conducted to determine whether organ damage has occurred, such as blood tests for BUN and creatinine levels, an echocardiogram or ultrasound to check heart function, and a urine test to assess kidney function. Other tests may include an ECG, renal ultrasound, eye exam, CT or MRI scan of the brain, and chest X-ray.

Immediate medical attention is necessary for a hypertensive emergency, and treatment usually involves the use of high blood pressure medications given intravenously. Once stabilized, the patient may be prescribed oral blood pressure medication and require regular checkups to monitor their blood pressure.

Prevention of a hypertensive emergency involves regularly checking blood pressure, taking prescribed medication as directed, maintaining a healthy lifestyle, treating underlying health conditions, and seeking immediate medical attention if symptoms develop.

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