High blood pressure (hypertension) is a sustained elevation of arterial pressure. Stage 1 hypertension begins at readings of 130–139/80–89 mmHg, and Stage 2 at ≥140/90 mmHg. Chronic hypertension increases risks for heart attack, stroke, and organ damage, making timely recognition and response vital
High blood pressure, which is also known as hypertension, occurs when the force of blood pushing against a person’s artery walls is consistently too high. Due to this, the person’s heart has to work harder to pump blood.
Recognizing Hypertensive Urgency vs. Emergency
Hypertensive emergency: blood pressure ≥180/120 mmHg with signs of end-organ injury (e.g., chest pain, neurologic deficits)
Hypertensive urgency: systolic ≥180 mmHg or diastolic ≥120 mmHg without acute organ damage.
Causes of High Blood Pressure
There are two types of hypertension, namely essential or primary hypertension and secondary hypertension, and they both have different causes.
Primary Hypertension
When the cause of high blood pressure is not identifiable, it’s known as primary or essential hypertension. This is the type of hypertension which develops with time, and it’s also the most common type of high blood pressure.
The causes of primary hypertension are:
- Lack of physical activity
- Having unhealthy eating patterns, including high intake of sodium
- High alcohol consumption
Secondary Hypertension
Secondary hypertension takes place due to an underlying condition. It often appears suddenly and could become more serious than primary hypertension. Some of the causes of secondary hypertension include:
- Obstructive sleep apnea
- Use of illegal drugs
- Adrenal gland problems
- Side effects of certain medications
- Kidney disease
- Congenital heart defects
- Chronic consumption of alcohol
- Issues with thyroid
- Certain endocrine tumors
Symptoms of High Blood Pressure
The symptoms of high blood pressure aren’t always too evident, even when the readings go too high. A person can have high blood pressure for a very long time without ever displaying any symptoms.
Some of the symptoms which could show themselves in certain individuals with high blood pressure are:
Nosebleed
- Shortness of breath
- Headache
The symptoms, however, don’t always show up until a person’s high blood pressure becomes life-threatening or too severe.
Someone with high blood pressure could be recommended a couple of medications by their healthcare provider till they find one medication or a combination of them that works well.
When to Seek Emergency Care
Call emergency services without delay if any of the following occur along with BP ≥ 180/120 mmHg:
- Chest pain, pressure, or radiating discomfort
- Sudden vision changes or slurred speech
- Weakness or numbness (especially one-sided)
- Severe headache, vomiting, or confusion
- Seizure or altered consciousness
Immediate First Aid Steps
- Create a Calm Environment
- Sit the person upright in a quiet, comfortable space.
- Loosen tight clothing to enhance circulation.
- Guided Breathing
- Practice slow, diaphragmatic breathing: inhale through the nose for 4 seconds, exhale through the mouth for 6–8 seconds.
- Repeat for 3–5 minutes to activate the parasympathetic response and lower pressure.
- Hydration
- Offer a glass of water; even mild dehydration can constrict vessels and elevate blood pressure.
- Avoid high-sodium sports drinks or unapproved supplements.
- Use As-Needed Prescriptions
- If previously prescribed “rescue” antihypertensives (e.g., clonidine), administer per physician’s directions.
- Never double-dose or borrow medications.
- Monitor and Reassess
Long-Term Management & Prevention
- Take maintenance antihypertensive medications exactly as prescribed; do not skip doses.
- Adopt the DASH diet: emphasize whole grains, fruits, vegetables, lean proteins, and low-fat dairy.
- Engage in ≥150 minutes of moderate exercise per week (e.g., brisk walking).
- Practice regular stress-reduction: mindfulness, yoga, or guided relaxation.
- Limit sodium intake to <2.3 g/day, avoid tobacco, and moderate alcohol to ≤1 drink/day for women or ≤2 for men
Do’s and Don’ts
| Do | Don’t |
|---|---|
| Keep the person seated and calm | Bend over or lie flat, which can worsen symptoms |
| Use measured deep-breathing techniques | Rely on rapid, shallow breaths or breath-holding |
| Offer water for mild dehydration | Give caffeinated, alcoholic, or high-sodium drinks |
| Administer prescribed as-needed meds per guidance | Share or guess dosages of antihypertensive drugs |
| Call EMS immediately for red-flag symptoms | Delay seeking professional help when organ-damage signs appear |
Prevention
There are a couple of things one can do to reduce the risk of developing high blood pressure. They are as follows:
- Maintain a healthy diet.
- Get rid of any excess weight and attempt to maintain a healthy weight.
- Stay active by engaging in physical activities.
- Watch your alcohol intake.
- Reduce your intake of sodium.
- Don’t smoke.
- Manage your stress levels.
REFERENCES
- Dr. Uvesh Mansuri, First Aid for High Blood Pressure, April 11, 2022, https://bpincontrol.in/blood-pressure-guide/first-aid-for-high-blood-pressure/
- Helen Jahn, First Aid for High Blood Pressure: What to Do During a Sudden Hypertensive Crisis at Home, March 24, 2025, https://mednewspedia.com/first-aid-for-high-blood-pressure/
- Causes: High blood pressure. (2023).
https://www.nhs.uk/conditions/high-blood-pressure-hypertension/causes/ - Mohammedin A, et al. (2022). Assessment of hydration status and blood pressure in a tertiary care hospital at Al-Khobar.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441182/ - John Furst, First Aid for High Blood Pressure: 7 Effective Steps to Take, December 4, 2023, https://www.firstaidforfree.com/first-aid-for-high-blood-pressure/
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