Identifying risk factors for hypertensive emergencies can help you take steps to prevent this dangerous condition. Awareness of these factors empowers you to keep a closer eye on your health and work with your healthcare provider to take control of your blood pressure.
Demographic Risk Factors
Age and sex impact the risk of the onset of a hypertensive emergency. Older adults face higher odds of experiencing hypertensive emergencies compared to younger people.
The reasons include age-related changes that affect blood pressure regulation and a higher likelihood of having comorbidities, two or more diseases simultaneously. Men also have increased susceptibility compared to women, possibly due to hormonal influences.
If you are an older male, you are in the highest-risk demographic category for a hypertensive emergency. Therefore, it is important to monitor and treat your blood pressure carefully. Work closely with your doctor to stabilize your blood pressure, particularly if you have other risk factors.
Certain health conditions raise the risk of hypertensive crisis. Having one or more of these comorbidities means you need to be extra vigilant about controlling your blood pressure:
Chronic Kidney Disease
Kidney disease nearly triples the likelihood of a hypertensive emergency. High blood pressure damages the kidneys, but kidney dysfunction also makes it harder to regulate blood pressure. This two-way relationship means chronic kidney disease and hypertension exacerbate each other.
Coronary Artery Disease
Coronary artery disease increases the odds of hypertensive emergency by over 65%. High blood pressure significantly strains the cardiovascular system and contributes to atherosclerotic plaque buildup in arteries. Meanwhile, impaired blood flow from occluded arteries further raises blood pressure.
Congestive Heart Failure
Failing hearts have difficulty pumping blood efficiently. This results in fluid backup and reduced oxygen circulation, which spikes blood pressure. High blood pressure also taxes the heart and worsens heart failure. This vicious cycle makes heart failure a predictor of hypertensive crisis.
Prior stroke or transient ischemic attack is linked to around 76% higher hypertensive emergency odds. Hypertension is a significant risk factor when it comes to cerebrovascular events. At the same time, blood vessel damage in the brain disrupts blood pressure regulation.
Diabetes makes hypertensive crises slightly over 72% more likely. The reasons relate to kidney problems, hardening of arteries, and fluid balance issues often associated with diabetes. High blood sugar also impairs endothelium function necessary for blood pressure regulation.
High cholesterol doubles the risk of hypertensive emergencies. Atherosclerotic changes from lipid accumulation interfere with blood pressure control by stiffening arteries and impairing blood flow.
Certain substances also raise hypertensive crisis risk:
Excessive drinking is strongly associated with hypertensive emergencies. Alcohol impacts blood pressure through several mechanisms. Consuming more than modest quantities of alcohol leads to fluid retention and activation of the sympathetic nervous system. Over time, it can cause cardiovascular damage and weight gain, which contribute to hypertension.
The use of cocaine, amphetamines, and other stimulants substantially increases the likelihood of hypertensive crisis. These drugs trigger surges in blood pressure through their effects on heart rate, blood vessel constriction, and fluid balance.
Avoiding illegal drugs is essential for controlling blood pressure. If you regularly drink more than moderate amounts of alcohol or use any illegal drugs, your risk of hypertensive emergency shoots up steeply.
Cutting out alcohol and drugs entirely reduces the odds of a life-threatening blood pressure spike. Be transparent with your healthcare provider about any substance you may be using so you can get help managing this serious risk factor.
You may expect blood pressure readings to be dramatically higher during hypertensive crises versus less urgent scenarios. However, the data shows surprisingly minor differences in systolic and diastolic blood pressure when comparing hypertensive and non-emergency hypertensive urgencies.
While severe high blood pressure is a defining feature of hypertensive emergency, measurements alone do not predict impending organ damage. Extreme blood pressure elevations without symptoms may represent urgency rather than an emergency. Likewise, organ damage can occur at lower blood pressure thresholds in susceptible individuals.
Therefore, doctors cannot rely on blood pressure measurements alone when evaluating hypertensive crises. They must also assess for neurological changes such as confusion or vision loss, chest pain, shortness of breath, and other signs of target organ complications.
This means being alert to symptoms of organ damage at any blood pressure level. Do not simply assume slightly lower readings indicate you are out of the danger zone for a hypertensive emergency. Persistent hypertension of any degree calls for caution and medical evaluation.
Reduce Your Risk of a Hypertensive Crisis with Imperial Center Family Medicine
Based on the wide range of risk factors, it’s clear that anyone can experience a hypertensive crisis. The good news is that you can prevent it. Just knowing the major risks allows you to take steps to lower your susceptibility. Imperial Center Family Medicine’s experts can perform a comprehensive risk check and partner with you on a treatment plan tailored to your needs.