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Acute — Needs Attention

🩺Hypertensive Crisis / Dangerously High Blood Pressure

Blood pressure above 180/120 mmHg with symptoms. A hypertensive emergency can cause stroke, heart attack, or kidney failure if not treated urgently.

What To Do — Step by Step

1

Recognise the signs: severe headache at the back of the head, blurred or double vision, nausea and vomiting, shortness of breath, chest pain, confusion or difficulty thinking, nosebleed that will not stop.

2

Sit or lie the person down quietly. Rest significantly lowers blood pressure — do not leave them standing or agitated.

3

Measure blood pressure if a cuff is available. Above 180/120 with symptoms is a hypertensive emergency.

4

Loosen any tight clothing around the neck and chest.

5

Keep the person absolutely calm. Stress and anxiety directly raise blood pressure further.

6

If the person is on prescribed blood pressure medication and has missed doses, they may take their regular medication now — but do not give extra doses.

7

Do not give any over-the-counter medication to lower blood pressure unless specifically prescribed for hypertensive crises.

8

Get the person to a hospital or clinic with blood pressure monitoring and medication as quickly as possible.

9

Monitor for neurological symptoms — confusion, weakness of one side, slurred speech. These indicate stroke and require emergency response.

Go To Hospital Immediately If

Sudden severe headache with vision changes — possible hypertensive encephalopathy or stroke.

Weakness or numbness on one side of the face or body — stroke.

Slurred speech or sudden confusion.

Chest pain with high blood pressure — possible heart attack.

Shortness of breath with high blood pressure — possible heart failure.

Hypertension in pregnancy with headache and swelling — eclampsia.

Nosebleed that will not stop with standard first aid.

Important Warnings

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Do not give nifedipine capsules to bite and swallow — this outdated practice causes a dangerous rapid drop in blood pressure.

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Do not try to lower blood pressure too quickly at home — a rapid drop is as dangerous as a high reading.

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Do not give extra doses of blood pressure medication without medical guidance.

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A person with consistently high blood pressure needs long-term daily medication — this is not optional.

Pharmacy Guidance

✓ What Helps

· Continue prescribed blood pressure medication consistently every day — this is the most important action

· Monitor blood pressure regularly at a pharmacy or clinic

✗ What To Avoid

· Biting nifedipine capsules — causes dangerous rapid blood pressure drop

· Salt in any form — reduce dietary salt permanently

· Alcohol — raises blood pressure acutely

· Extra doses of any antihypertensive without medical advice

→ Ask The Pharmacist For

· Prescription antihypertensive medications — amlodipine, lisinopril, or hydrochlorothiazide are common first-line choices

· Regular blood pressure monitoring at a clinic

· Lifestyle counselling on diet, exercise, and salt reduction

🏥 Get Professional Help

Go to hospital immediately for blood pressure above 180/120 with symptoms, any neurological symptoms, chest pain, or significant shortness of breath. All people with high blood pressure need regular medical follow-up and consistent daily medication.

This guidance is based on universal medical protocols. It does not replace a doctor. Seek professional medical help as soon as possible.