high blood pressure
Blood pressure readings above 180/120 mmHg are considered stroke-level and dangerously high

A severe increase in blood pressure that can lead to a stroke is called a hypertensive crisis. Extremely high blood pressure can damage blood vessels and weaken arteries in the brain, increasing the risk of stroke.

Blood pressure readings above 180/120 mmHg are considered stroke-level, dangerously high, and require immediate medical attention.

High blood pressure, or hypertension, is the leading cause of strokes in the U.S. However, understanding risk factors and blood pressure readings can help people seek appropriate treatment:

Table. The stages of hypertension
Blood pressure category Systolic (mm Hg) Diastolic (mm Hg)
Normal Less than 120 Less than 80
Prehypertension 120 to 129 Less than 80
Hypertension stage I 130 to 139 80 to 89
Hypertension stage II 140 or above 90 or above
Hypertensive crisis More than 180 More than 120

What are symptoms of high blood pressure?

While hypertension is sometimes called the silent killer because most people show no symptoms, a few common signs of the condition include: 

Rare symptoms may include:

What are the different types of hypertension?

There are two types of hypertension:

  1. Primary hypertension or essential hypertension is the most common type, and there is no known cause for it.
    • This type of high blood pressure usually takes many years to develop is often the result of lifestyle, environment, and older age.
  2. Secondary hypertension is caused by another health problem or medication:
    • Kidney problems
    • Sleep apnea
    • Thyroid or adrenal gland problems
    • Side effects of some medications


Salt and sodium are the same. See Answer

What are treatment options for high blood pressure?

Treating high blood pressure may include a combined approach of dietary changes, medication and exercise. The goal is to lower your blood pressure and thus lower your risk of developing health problems caused by high blood pressure. 

  • Prehypertension
    • If your blood pressure is between 120/80 mm Hg and 130/80 mm Hg, your doctor may recommend lifestyle changes like losing weight or quitting smoking to help bring blood pressure down to a normal range. Medication is rarely used at this stage.
  • Stage I hypertension
    • If your blood pressure is above 130/80 mmHg but below 140/90 mmHg, your doctor may prescribe a blood pressure medication in addition to recommending lifestyle changes.
  • Stage II hypertension
    • If your blood pressure is above 140/90 mmHg, your doctor may start you on more rigorous medications and recommend stricter lifestyle changes. Medications may include:
      • Diuretics or water pills help kidneys remove some salt (sodium) from the body. As a result, blood vessels do not have to hold as much fluid and normal blood pressure can be maintained.
      • Beta-blockers lower stress on the heart and blood vessels.
      • Angiotensin-converting enzyme inhibitors (also called ACE inhibitors) help relax blood vessels and lower blood pressure as a result.
      • Angiotensin II receptor blockers (also called ARBs) work the same way as angiotensin-converting enzyme inhibitors.
      • Calcium channel blockers relax blood vessels by reducing the amount of calcium entering cells.
      • Alpha-blockers help relax blood vessels and lower blood pressure as a result.
      • Centrally acting drugs send signals to the brain and nervous systems to relax blood vessels.
      • Vasodilators help muscles in the walls of blood vessels to relax.
      • Renin inhibitors are a new type of medication that reduces the amount of angiotensin precursors, relaxing blood vessels.

What are the side effects of blood pressure medication?

Common side effects of high blood pressure medicines include:

When should you go to the ER with high blood pressure?

what is considered stroke-level high blood pressure?
A reading of 180/120 mm Hg or higher is considered a hypertensive crisis and requires immediate medical attention.

According to the American Heart Association (AHA), a reading of 180/120 mm Hg or higher is termed a hypertensive crisis and requires immediate medical attention. If this reading is consistent two times in a row, five minutes apart, then you must head to the nearest emergency room immediately.

Blood pressure (BP) is the force applied against the walls of the arteries by the blood that the heart pumps through the four chambers into major arteries that transport blood throughout the body through the circulatory system.

According to the AHA, normal BP in adults is 120/80 mm Hg. However, according to the new guidelines issued by the AHA, the goal BP for all adults is now less than 130/80 mm Hg.

According to guidelines by the American College of Cardiology/American Heart Association, hypertension is a term to describe high BP that measures consistently above 130/80 mm Hg or higher.

Hypertension affects one-third of Americans and is a considerable risk factor for cardiovascular diseases such as heart attack and heart failure, stroke, renal diseases, and death.


How to Lower Blood Pressure: Exercise and Tips See Slideshow

What causes hypertension?

Hypertension is often called a “silent killer” because it may cause no noticeable symptoms.

It can be a result of the following:

  • Age (blood pressure increases with age)
  • Gender (men are more likely to develop hypertension than women)
  • Family history
  • Unhealthy lifestyle (lack of exercise, sedentary lifestyle, and consumption of junk and processed foods are modifiable factors)
  • Excessive salt intake
  • Decreased or no physical activity
  • Obesity
  • Diabetes
  • High cholesterol
  • Stress
  • Pregnancy
  • Alcohol consumption
  • Smoking

What is a hypertensive crisis?

Depending on the severity, a hypertensive crisis is divided into two types, including:

  1. Hypertensive urgency: It is an elevation of blood pressure (BP) more than 180/120 mm Hg with no associated symptoms. In this condition, you can wait for five minutes and then take the readings again. If the recordings are the same, seek medical help immediately.
  2. Hypertensive emergency: This stage requires immediate medical attention and hospitalization. It is defined as severe high BP that exceeds 180/120 mm Hg, along with the presence of acute target organ injury with symptoms such as

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Medically Reviewed on 3/9/2022
Image Source: iStock Images

WebMD. Symptoms of High Blood Pressure. https://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-symptoms-high-blood-pressure/

Severe Asymptomatic Hypertension American Family Physician: https://www.aafp.org/afp/2017/0415/p492.html

Understanding blood pressure readings: https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings

Things you need to know about blood pressure and hypertension NIH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2560868/

Hypertensive Crisis: https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/hypertensive-crisis-when-you-should-call-911-for-high-blood-pressure