The difference between hypertensive crisis and hypertensive encephalopathy

Written by Wang Ji Zhong
Internal Medicine
Updated on August 31, 2024
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Both hypertensive encephalopathy and hypertensive crisis involve a rapid increase in blood pressure, symptoms of headache, restlessness, nausea and vomiting, palpitations, shortness of breath, and blurred vision, with systolic pressure increasing to 200 mmHg and diastolic pressure to 120 mmHg, typically presenting similar clinical blood pressure readings. The main difference between the two is that hypertensive encephalopathy is based on excessively high blood pressure in patients with severe hypertension. Furthermore, hypertensive encephalopathy can lead to clinical signs of cerebral edema and increased intracranial pressure, whereas hypertensive crisis occurs when blood pressure suddenly rises over a short period, causing symptoms due to excessive secretion of catecholamines driven by increased sympathetic nervous excitement.

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What is the blood pressure in a hypertensive crisis?

Hypertensive crisis is a relatively urgent medical condition in clinical settings. Its diagnostic criterion is a diastolic pressure greater than 130 mmHg. Naturally, the higher the blood pressure, the greater the threat. A hypertensive crisis can lead to many clinical symptoms, such as acute left heart failure, dizziness, headache, cerebral hemorrhage, and acute renal failure. The most common causes of hypertensive crisis are primary or secondary hypertension, which, under certain specific circumstances, lead to uncontrollably high blood pressure and related clinical symptoms. The focus of treatment is on controlling the blood pressure and choosing different treatment plans for complications. For instance, in the case of heart failure, vasodilators and diuretics may be used for symptomatic treatment.

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Is a blood pressure of 150 severe?

A blood pressure of 150 mmHg is not necessarily serious by itself; further risk stratification of blood pressure needs to be conducted. If the risk stratification of blood pressure is high or very high, the condition is relatively serious and active antihypertensive treatment is necessary to effectively reduce the future risk of cardiovascular and cerebrovascular events, thus improving the patient's prognosis. If the blood pressure of 150 mmHg is classified as low or medium risk, this level of blood pressure is not serious, but it still requires long-term standardized treatment to control the blood pressure to the target level. If blood pressure is not well controlled, long-term hypertension can gradually make the condition very serious, increase the risk stratification, and significantly raise the likelihood of cardiovascular and cerebrovascular events.

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As living standards improve, a blood pressure monitor has become an essential medical device in households. Electronic blood pressure monitors are very convenient for measuring blood pressure, especially for patients with hypertension. They allow patients to measure their blood pressure timely and adjust medication dosages accordingly. How to read a blood pressure monitor varies with different models. Typically, on an electronic blood pressure monitor, the first line displays the systolic pressure, also known as high blood pressure; the second line displays the diastolic pressure, also known as low blood pressure; and the third line displays the heart rate. These readings can help you know your systolic and diastolic pressures.

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The difference between hypertensive emergency and hypertensive encephalopathy.

The so-called hypertensive emergency is a condition where blood pressure rises very quickly, reaching a very high level in a short period of time. At this time, it does not necessarily lead to hypertensive encephalopathy, which is a more dangerous condition. Hypertensive encephalopathy indicates that due to the rapid rise in blood pressure, the pressure in the brain's blood vessels becomes excessively high. This pressure causes cerebral edema. At this point, because the blood pressure is higher than the brain's perfusion pressure, the brain becomes swollen, which is extremely dangerous. If the swelling is severe, it may lead to brain herniation, which can be fatal. Therefore, relatively speaking, hypertensive encephalopathy is much more serious than a hypertensive emergency and represents a dangerous stage of progression within a hypertensive crisis. Thus, hypertensive encephalopathy is a very dangerous condition and is one of the most critical manifestations within a hypertensive emergency.

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Is pregnancy hypertension dangerous?

Pregnancy-induced hypertension is a relatively dangerous disease because it has a significant impact on both the pregnant woman and the fetus. Firstly, it can cause the pregnant woman to have proteinuria, edema, and high blood pressure. If the blood pressure rises further, it may lead to cerebral hemorrhage, brain herniation, convulsions, etc. Additionally, if there is a lot of proteinuria, the whole body can become swollen, and as the protein is lost with the urine, the fetus's growth and development can be restricted, leading to reduced weight. Furthermore, the fetus may also experience hypoxia, changes in fetal heart rate, and intrauterine fetal demise.