Can someone please explain hypertensive crisis to me?

[BossyBitch]

My mother was admitted to ICU with a blood pressure of 270/110 today. After 6 hours on a drip it's still at 225/97 or thereabouts.

The doctors seem clueless at what the problem seems to be. I'm currently assuming that she's not about to die as the consultant says not need to ask my sister to come home from overseas.

I'm trying not to google as, according to the internet any symptom is inevitably fatal but I'd really like to understand what this actually means.

Is my mum in acute danger? If I'm not meant to call my sister home, then why do the medical professionals seem so worried about her blood pressure not coming down?

What's the prognosis? And what on earth does Wikipedia mean by patients usually dying within an average of 3 years without proper treatment? Can they treat her properly if they don't understand why?

I'm terrified and I'm alone in a hotel here, having flown in after being alerted by text today.

I won't go back till tomorrow since having visitors, even doctors and nurses, seems to make mum's blood pressure spike, and I'm really not wanting to put her at risk.

Would really appreciate some explanation!

Also, what questions am I meant to be asking?

Hi.My dh has a hypertensive crisis 6 years ago. He's still here. I think his numbers were higher than your mum's. I totally understand why you are scared. My Dh went into the high dependency unit and they gave him intravenous blood pressure meds. I remember ringing up and his nurse saying what his numbers were each time and I remember thinking they were going down really slowly. But just had to wait it out. If they are not saying to get your sister there I'm sure that's quite a good sign. Obviously your mum's situation and the causes could well be very different. I just wanted to let you know I've been in your situation, it's very scary, especially when they don't know what's going on yet. But Dh blood pressure currently good with ongoing treatment. Also it's definitely the best place for her to be. Hypertension can often be undetected. Thinking of you.

Does your mum already have a condition which was being treated?

Reading your posts again:- the blood pressure meds should mean she will be treated ok without knowing the cause. I'd ask about blood test results and what they can learn from them. I think the main problem with blood pressure being high is what it causes in other systems in the body.

Sorry stuff keeps coming back to me. Dh also had ecg, echocardiogram and, I think, mri over the first few days that he was in hospital .

Thank you, @tobee, hearing your DH is still around certainly helps. Any idea how long it took them to lower his BP to somewhat normal values? Mum's been on a drip for >8hrs at this point and hers is still at levels that would warrant an emergency admission.

This is just all very, very confusing and scary! Being here by myself and not understanding what seems to be the problem isn't helping.

I'm really just panicked and in tears at this point. And I'd love a nice glass of wine but dare not touch one in case she takes a sudden turn for the worse and I need my wits about me.

And, yes, they obviously gave her some test. CT to check for stroke came back looking good, as did a chest x-ray, apparently.

Some minor abnormalities on her ECG apparently, though they couldn't quite say what (or explain it in terms that were intelligible to me - I'm educated and a professional but nowhere near the medical field).

They're talking about urine samples tomorrow. I guess that means they must be worried about renal failure?

Yes, I'm afraid renal failure is a possibility. It can become cyclical I believe. The blood pressure effects the kidneys and the damaged kidneys escalate the blood pressure. And so on.

Dh didn't become near normal for over 24 hours, possible more like 48 - 72. So sorry I can't remember more clearly.

Dh has renal failure, but is currently doing well on dialysis.

Someone told me once that the reason they reduce BP slowly is because doing it fast can cause smaller blood vessels (e.g. In the eyes) to collapse because they are used to the pressure.

Just spoke to ICU again. Seems like her blood pressure is finally coming down and she's fast asleep. Duty nurse says she's very happy indeed with the development.

I'm so relieved that I'm actually in tears!

That's excellent news! It's a horrible worry at first, isn't it?

Horrible is putting it mildly. Having raced to the airport and sat through a flight thinking I might not make it in time to see my mother alive only to find her coherent and talking but with doctors seemingly at a loss as to how to stabilise her spiking blood pressure ... well, it's certainly been an experience I don't care to repeat any time soon.

I'm physically and emotionally exhausted and I've not felt so alone in years!

I'll pop back in tomorrow and then hopefully arrange with my boss to be working remotely for a few days.

The thing is, though, I have committments and people who depend on me, so I won't be able to stay indefinitely. I really wish my sister wasn't a continent away. She keeps on texting and demanding that I ask this and ensure that - but she's not here to help, hasn't been around to see mum or dad in half a decade and won't be in a position to contribute financially if needed. And yet, somehow, I'm the bad sibling because I work for megacorp, not a charity like her.

Sorry, I'm just rambling now. This is just my exhaustion talking.

Ramble away if it helps with the stress.

ramble away.
text your sister back that you will keep her informed. she means well and is worried just like you.