When should I call my doctor or seek help if I have chronic hypertension?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

You should have a treatment plan for your chronic high blood pressure, and your healthcare provider can help you. Usually lifestyle changes are recommended like quitting smoking, eating right and limiting alcohol, and generally medications like diuretics, beta blockers, ACE inhibitors and others are prescribed as needed. Your doctor will help you find the medication or combination of medications that works best. Make sure to adhere to the program and let your doctor know about all medications and supplements you are taking. Call your doctor if you have a bad reaction to any medication.

Otherwise, if you get a blood pressure reading of 180/120 or higher, but have no other symptoms, wait five minutes and test your blood pressure again; if it persists, call your doctor. Signs of a hypertensive emergency, when blood pressure has risen dangerously high, can include back pain, severe headache or anxiety, shortness of breath, numbness or weakness, and inability to speak; this requires emergency care.

Edtrina Moss
Ambulatory Care Specialist

Managing high blood pressure requires an understanding of why blood pressure is important, what your normal range should be, and knowledge of specific lifestyle changes that may be necessary to ensure your success in managing your disease.

Blood pressure is the force of blood pumped from the heart to the arteries throughout the body. This is called the systolic pressure (the top number of the blood pressure reading). The second force is when the heart rests between beats. This is called the diastolic pressure (the bottom number of the blood pressure reading). The top or systolic number is the higher of the two numbers.

The American Heart Association's guidelines for normal blood pressure is the systolic (top number) less than 120 and the diastolic (bottom number) less than 80. High blood pressure is a systolic range of 140-159 and a diastolic range of 90-99.

If you are 20 years or older, you should have your blood pressure screened at each provider visit or annual wellness visit. This preventive approach is the best way to identify changes in your blood pressure over time. If you have been diagnosed with high blood pressure, talk to your healthcare provider about what times would work best for you to measure and record your blood pressure between visits. This will assist your provider in identifying the best approach to treatment during your visit. Create alarms or reminders that help you remember to take any blood pressure medication prescribed by your provider. It is also important to discuss with your provider the administration or dosing times that work best for you so that you are more successful with medication adherence. It is recommended to use the assistance of a dietician or nutritionist to assist you with food planning that limits salt intake while maintaining cultural or ethnic traditions. Finally, make exercising a part of your lifestyle so that your routine does not interfere with other competing demands.

If you find you are still challenged with managing your blood pressure at healthy levels, take time to visit with your provider to discuss additional medications options, modifications, and a specific plan to help you decide when it is necessary to contact the office or seek emergency care.

The best approach to managing chronic hypertension is a proactive one. These tips can help you manage hypertension so that it doesn't manage you.

If you have chronic hypertension, you should call your healthcare provider if your BP is higher than normal and does not go down, even after taking your medicines exactly as you have been told to. If you have the following symptoms, call your healthcare provider or seek immediate help:

  • a very bad headache, dizziness, trouble thinking clearly (confusion) or problems with understanding things or talking
  • chest pain or discomfort that spreads to your arms, jaw or back
  • lips or nail beds that turn blue or white in color
  • nausea (upset stomach), sweating or trouble breathing
  • inability to see out of one or both of your eyes
  • unusual, sudden back pain
  • weakness or numbness in your arm, leg or face. This may happen on only one side of your body.

You should also call your healthcare provider if you have any questions or concerns about your condition, medicine or care.

Seek immediate medical help if you have chronically high blood pressure and

  • the systolic (upper) blood pressure number is over 180; or
  • the diastolic (lower) blood pressure is over 110.
  • However, there are no set numbers that apply to each individual.

When your blood pressure is this high, you have (or may not) have these symptoms:

  • anxiety
  • chest pain
  • difficulty breathing
  • headache
  • numbness or tingling
  • vision changes

These are signs that your blood pressure is causing organ damage. This is an emergency. Call 911 for help.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.