Hypertensive Crisis: What It Is, What Causes It, and How to Respond

A hypertensive crisis, a sudden, dangerous rise in blood pressure that can damage organs and lead to stroke, heart attack, or kidney failure. Also known as malignant hypertension, it’s not just a bad day with high numbers—it’s a medical emergency that demands quick action. If your blood pressure hits 180/120 mm Hg or higher, especially with symptoms like chest pain, blurred vision, or confusion, you’re in a hypertensive crisis. This isn’t something to wait out or take a nap after. Every minute counts.

What triggers it? Often, it’s something you can control. Skipping blood pressure meds, using illegal drugs like cocaine, or taking decongestants like pseudoephedrine can push your pressure into danger zone. Even some over-the-counter painkillers like NSAIDs—think ibuprofen or naproxen—can cause this if you’re already hypertensive. People on corticosteroids, medications like prednisone used for inflammation or autoimmune conditions are at higher risk too, because these drugs cause fluid retention and tighten blood vessels. And if you have untreated high blood pressure, even a stressful event or a bad night’s sleep can be the final push.

It’s not just about the number on the machine. A hypertensive urgency, a severe rise in pressure without organ damage is serious but not immediately life-threatening—you still need to see a doctor within hours. But if you’re having headaches, nausea, vision changes, or trouble breathing along with that high number, you’re likely facing a hypertensive emergency, where organs like the brain, heart, or kidneys are already being damaged. That’s when you need to go to the ER, not wait for your next appointment.

Some medications can make this worse without you realizing it. Drugs like MAO inhibitors, used for depression and sometimes Parkinson’s, can interact badly with certain foods or other meds and spike pressure. Even some herbal supplements, like licorice root or ephedra, can do the same. And if you’re on blood pressure meds but still getting readings this high, it might mean your body isn’t responding anymore—or you’re not taking them right.

Knowing the signs saves lives. Most people don’t feel high blood pressure until it’s already hurting them. That’s why a hypertensive crisis often catches people off guard. But if you’ve been told you have high blood pressure, keep a home monitor. Track your numbers. If you see a sudden jump—even if you feel fine—call your doctor. Don’t wait for symptoms. And if you’re on meds, never stop them cold turkey. That’s one of the most common causes of rebound hypertension.

The posts below cover exactly what you need to understand this risk. You’ll find clear breakdowns of how common drugs like NSAIDs and corticosteroids can trigger dangerous spikes, how to monitor your pressure at home, and what to do when things go wrong. You’ll also see how other conditions—like kidney disease or pregnancy complications—can tie into this. No fluff. No guesswork. Just the facts you need to protect yourself or someone you care about.