zuzu8

Your mother is having what they call a hypertensive crisis, which is basically any severe or critical sustained elevation in blood pressure. The third doctor was right to hospitalize her when her BP wasn't coming down on Metropolol (which is a beta blocker and very commonly prescribed for hypertension)

There are basically two kinds of hypertensive crisis: hypertensive EMERGENCY and hypertensive URGENCY.

A hypertensive EMERGENCY, is when there is acute or ongoing end-organ damage (i.e. damage to heart or kidneys).

The absence of such complications is known as a HYPERTENSIVE URGENCY.

Hypertensive "emergencies" generally require a reduction in blood pressure within a few hours, if not faster than that, usually using intravenous medications given in an intensive care unit.

Hypertensive "urgencies" also require prompt medical attention, but blood pressure can be lowered over 24 to 48 hours, sometimes in a closely monitored outpatient setting, not necessarily in the hospital.

It appears that because your mom was not hospitalized initially, the first two doctors felt it was an urgent situatuion but not necessarily an emergency.

It's better that she's now in the hospital, where they can monitor her BP closely and can run tests to check her heart and kidneys to see if there are problems there.

The most common causes of hypertensive crisis are:

Several kidney disorders and diseases (both chronic and acute).
Scleroderma and other collagen vascular diseases.
Use of certain drugs, particularly sympathomimetic agents (eg, cocaine, amphetamines, PCP, LSD).
Withdrawal from antihypertensive meds.
Eating tyramine-containing foods.
Taking tricyclic antidepressants, or other sympathomimetics combined with MAO inhibitor therapy (again, certain drugs).
Preeclampsia, eclampsia.
Pheochromocytoma (a tumor of the adrenal glands).
Head injury
Renin-secreting or aldosterone-secreting tumor.
Vasculitis.
Autonomic hyperactivity in presence of Guillain-Barré or other spinal cord syndromes.

Try not to worry too much at this point. There are medications that they can use to stabalize her BP, (she may need more than one) and once under control, they will, as I said, run tests in a controlled environment to find what could have caused this to happen.

But don't let that list scare you.... none of the above are necessarily her problem and she simply might need better BP control than in the past.


zuzu xx