Hypertensive Urgency/Emergency Blood Pressure >180/120

[Richard9999]

In the UK we are advised by NHS 111 or our GP to head to the A&E department if our blood pressure spikes greater than 180/120 and there are one or more additional symptoms.

This happened to me twice in the past 6 months (never happened before this in 20 years). The first time it hit around 250/120 and it caused nose bleeding and dizziness and the second time just general dizziness.

Both times I was checked out in A&E - ECG, blood tests etc and both times everything absolutely fine. Despite the consultant in A&E confirming that 180/120 plus one or more symptoms was indeed the correct guideline and my GP was correct in his advise, I did question afterwards whether or not I should have made the trip to A&E or just gone straight to bed instead.

I am sure blood pressure spikes over 180/120 lasting a few hours are very common so what have people done in the same situation? Have you headed for A&E or taken a more relaxed view of things?

[Happyrosie]

what you’ve said, Richard, is fascinating. It does not accord with what happened to me (I was 185/something) and not with NICE guidelines! You can read the guidelines by going to the website of National Institute for Clinical Evidence and inputting hypertension to their search box.

So I think there might have been something else going on here, in your case. It might be your medical or family history, or your diet and lifestyle, or something else.

[Richard9999 in reply to Happyrosie]

Hi Happyrosie, thanks for the link to NICE guidelines, I haven't read these before. Some interesting pointers but to my mind assumes that you have face to face access to a GP who can assess you and who actually knows the current guidelines for referral! NHS 111 guidelines also differ which doesn't help.

[Happyrosie in reply to Richard9999]

how do you assess what 111 guidelines are? Are they published or do you ring them in crisis and this is what you get? Most interested to know!

[Richard9999 in reply to Happyrosie]

Happyrosie, NHS 111 is an online assessment tool that like into the wider NHS system. Essentially you complete a series of questions relative to your condition and it generates a response such as see your GP within the next few days, urgently or a consultant will call you within the next hour to discuss your condition. You can broadly work out the guidelines given the final answer or by speaking to the consultant.

[Happyrosie in reply to Richard9999]

I thought that's what it was. they are not published, then, to the wider population like NICE is.

I had forgotten this fact until your post reminded me: I did do a 111 consultation a couple of years ago. When I completed the form it told me to get an urgent GP consultation or to go to A&E which was completely ridiculous for the problem that I had. I kept going back and changing my answers but they still came up with the same conclusion. So I don't trust them!!!!!

[peter999999999]

i was let out of hospital with a bp of 180/95 said thats ok but you you wont have a heart tack etc,

[katieoxo60]

Hi Richard9999, I am sure spikes in blood pressure are common speaking from experience over a life time. In fact A&E departments can be the cause unfortunately, If you are taking tablets it is possibly a normal rise, due to your activity. Usually real problems have other symptoms however the lower we can keep the BP the better for us especially if in the older age group. If this helps I have always had a BP above 140/70 so do feel the figures are a bit difficult to get your head around as we would say today. Take care

[JoraEm]

This happened to me a few days ago. I also had severe chest pain like my heart was contracting. I immediately took some of my meds that I take in the evening and went to take a warm shower. It did finally come down to 150/100 but I was left shaken the rest of the day. If it does happen again I will head to A&E.

[Richard9999]

Hi JoraEm, hopefully your BP has returned to normal and you are ok now. I think severe chest pain and very high BP is a trip to A&E if it happens again, just to be on the safe side and to get things checked out. I agree these episodes can leave you shaken and a bit unsettled.

[Holiday12345]

I’ve been admitted to hospital a couple of times this year with very high bp and severe headaches and once with bad nose bleed but to be honest the docs said they don’t worry too much about high bp just check no end organ damage give you another pill and send you away. I’ve been let home with still extremely high bp a couple times. They complain that GPs panic at high numbers and said there’s thousands of folk walking about out there with very high bp that don’t know about it. 🤦‍♀️. That’s fine till something happens. I’ve had two mini strokes but my bp was normal then so much worse now so a bit of a worry. As I don’t tolerate bp meds well and have been on about 11 my hypertensive consultant is trying to de- medicalise it and I’m adding in beetroot juice, coconut juice meant to go low carb and reduced salt etc.only to do gentle walks on flat atm.