Robin Backlund, BHSc
A blood pressure reading of 186 over 82 (186/82) mmHg indicates that you are at a HYPERTENSIVE CRISIS, following the latest guidelines from the American Heart Association.
If you encounter such a reading, urgently call 911 or your local emergency number as this requires immediate medical attention.
While these figures are concerning for all – including children, adults, the elderly, and pregnant individuals – they can lead to severe complications such as stroke, heart attack, or kidney failure if neglected.
It’s crucial to understand that blood pressure readings can fluctuate based on age, gender, weight, and overall health; what’s deemed ‘good’ may differ based on individual medical history and existing health conditions.
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What does a 186 over 82 (186/82) blood pressure mean?
Blood pressure is a crucial indicator of one’s cardiovascular health. When readings soar to levels like 186/82, it’s a clear sign of a serious medical condition known as a hypertensive crisis.
This condition manifests when an individual’s blood pressure readings consistently exceed the 180/120 threshold.
mm Hg [upper #]
mm Hg [lower #]
Less than 80
Less than 50
Less than 90
Less than 60
Less than 120
Less than 80
Less than 80
Hypertension STAGE 1
Hypertension STAGE 2
140 or higher
90 or higher
Consult your doctor immediately
Higher than 180
Higher than 120
There are two primary classifications of a hypertensive crisis.
- Urgent Hypertensive Crisis: This is characterized by blood pressure levels that surpass 180/120 but do not result in damage to the body’s organs.
- Emergency Hypertensive Crisis: This is a more severe form where the 186/82 causes damage to end organs, necessitating immediate emergency care.
For context, a healthy individual’s ideal blood pressure range lies between 90/60 and 120/80. A reading of 186 over 82 mmHg is alarmingly high, indicating a significant deviation from optimal health.
Such elevated blood pressure levels place significant strain on the blood vessels, potentially stressing the heart and leading to further complications.
This can lead to an elevated heart rate, which, over time, can adversely impact cardiovascular health. In a study “High Blood Pressure and All-Cause and Cardiovascular Disease Mortalities in Community-Dwelling Older Adults” published in 2015 in Medicine Baltimore, consistently very high blood pressure is identified as a leading factor in increased mortality in the geriatric population.
If left untreated, a hypertensive crisis can pave the way for heart disease and other related complications, making it a crucial health metric that needs constant attention.
The most effective approach to manage and mitigate the risks associated with high blood pressure is through appropriate medication and lifestyle changes.
Consulting with a cardiologist or a specialized healthcare professional can provide tailored guidance, ensuring individuals embark on a path toward improved health and well-being.
Following are some of the clear indications that you have 186/82 blood pressure.
- Blurred and faded vision.
- Nausea and vomiting (blood sometimes).
- Chest pain and higher heart rate (arrhythmia).
- Severe headache.
- Confusion and lack of comprehension.
- Difficulty breathing.
- Excessive sweating.
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What should you do if you have 186/82 mmHg blood pressure?
Here is a set-by-step procedure to follow when you figure out you have a blood pressure of 186/82 mmHg.
1. Consult your doctor for accurate blood pressure reading
If your blood is 186 over 82 and you have checked the same in your home setup, it is highly recommended to get it checked at your doctor’s office.
A trained professional has to clinically assess your condition and confirm that your 186/82 is, in fact, clinically valid.
There are instances when your reading at-home setup might give you a reading which is incorrectly reported. It could be because of an error in reading it, damage to your device, your physical or mental condition on that particular day, etc.
So, it’s like the blood pressure plays hide and seek, depending on where you measure it!
All these conditions are linked to physiology and psychology and, therefore, better to be validated by a doctor.
2. Adopt these lifestyle changes to regulate your blood pressure
At 186/82 mmHg, you are needed to step into action to save your health and, more importantly, your life. Obviously, your doctor will immediately address this issue and stabilize you, but in the long run, you are needed to do some things.
Even though chemical drugs could ease your blood pressure, some lifestyle modifications are very important at this stage.
The first and foremost thing to keep in your mind is what goes inside your body. Your food is a critical factor to be bridled at this stage. You may need to critically scrutinize your eating habits as a first step.
Also, exercising needs to be incorporated only according to your doctor. Because at this stage, your body has already hit the maximum limit your blood vessels can handle. Therefore, consult your doctor and add some workouts to your life.
According to Harvard School of Public Health’s Healthy Living Guide 2020/2021, below are six suggestions that could help with your heart health.
- Have proper rest and sleep every day.
- Maintain a healthy body weight.
- Eat healthy meals and exercise daily.
- Quit smoking and limit the consumption of alcohol.
- Bring the substitutes of sodium salts into use.
- Do not indulge in stressful situations.
3. Consider using medications for blood pressure management
Medications and hospital care are the most important things at this stage. Your doctors might prescribe any one of the below classes of drugs alongside some treatment to handle comorbidities.
Researchers from George Washington University (Oster, J. R., Materson, B. J. & Perez-Stable) wrote a book in 2023 on Antihypertensive Medications, which recommends various guidelines, and according to it, all patients with stage 2 hypertension should start antihypertensive medications to achieve a blood pressure target lower than 130/80.
Here are a few of the popular classes of drugs that might be given to manage your 186/82 blood pressure.
- Diuretics (Water Pills): These are the medicines that help in the retention of sodium from the body by urination or sweating. This in turn, decreases sodium concentration in the bloodstream and helps lower high blood pressure.
- Calcium Channel Blockers: These are the medications that limit the mixing of calcium ions and compounds in the bloodstream. Calcium is actively responsible for the narrowing of blood vessels. By restricting it, relatively moderate blood pressure is ensured.
- Angiotensin II Receptor Blockers: these are medicines that consist of drugs that oppose the narrowing of the blood vessels. Using these, lower blood pressure is exercised in the blood vessels.
- Diltiazem: These are the medicines that control the minerals in the bloodstream that serve to be a possible cause of high blood pressure in people. These medicines regulate the concentration of the said minerals in the blood, hence lowering blood pressure.
- Beta Blockers: These are the medicines that help lower the pressure that is exerted over the heart, therefore lowering the heart rate. By lowering the heart rate, the pressure over the blood vessels is lowered.
4. Plan a diet specifically for 186/82 blood pressure
As mentioned above, whatever goes inside your body is a big matter of concern at this stage and therefore needs to be evaluated.
As you might have guessed, yes, you can have everything if your doctor has clinically diagnosed 186/82 mmHg.
You may need to follow a stringent diet plan to bring your pressure levels back to something that is more treatable and manageable.
The following are the factors that should be kept in mind when making your dietary plan for high blood pressure.
- Lower the sodium intake: Sodium can serve to be a major elevator for blood pressure. Hence, to get normal blood pressure, limiting its concentration in the bloodstream is necessary.
- Limit the alcoholic beverages: alcohol acts as a vasodilator, but in higher concentrations, it can also serve to increase blood pressure. So, only limited consumption of it is needed to be supported.
- Sugar: Added alongside the effects of high blood pressure, intake of excess sugar may lead to problems like diabetes and such.
- Caffeine: caffeine products are known to increase blood pressure in people. For those suffering from hypertensive crisis, this is a big no.
- Salts: instead of making use of sodium salt, it would be good if you were to consider the usage of other salts. Calcium and potassium salts serve as good substitutes for sodium salts.
- Herbs and spices: some spices and herbs are known to lower blood pressure to a great extent. If you were to include those in your diet, these would greatly benefit you.
5. Monitor for additional health conditions associated with blood pressure 186/82
If your blood pressure reading is 186 over 82 mmHg, then you may want to be extra careful and watch out for some health concerns explained below.
Hundreds of studies highlight the correlation between obesity and hypertension. Among them, there is a study “Highlights of mechanisms and treatment of obesity-related hypertension” published in 2022 in Nature by Elham Shams and his team, which clearly suggests that individuals with obesity are five times more likely to experience cardiovascular events.
If you are currently obese and your BMI is 30 or more, then a hypertensive crisis implies an impending stroke or heart attack.
In fact, obesity is identified as one of the major comorbidities that can aggravate your blood pressure condition.
Apart from that, kidney failure, diabetes, and sleep disorders are some of the other risk factors that can be associated with your 186/82 blood pressure.
One of the biggest risk factors is stress and anxiety, which can be deadly at this stage of your cardiovascular condition. Therefore, you may want to calm yourself down to keep things smooth.
6. Try natural supplements to support healthy blood pressure level
A meta-analysis study from 2022 “The Effect of Herbal Supplements on Blood Pressure: Systematic Review and Meta-Analysis” by Polish researchers from the Medical University of Lodz (Anna Lipert, Iwona Szadkowska, Ewelina Matusiak-Wieczorek, Ewa Kochan) reviewed the impact of nutraceutical products derived from cherry juice, beetroot juice, bergamot extracts, and barberry.
The study found that these substances significantly improved heart health by reducing high blood pressure levels.
Blood Pressure Support
Blood Pressure Optimizer
A person suffering from a hypertensive crisis needs to get through to a medical professional as soon as possible. This condition can lead to many possible life-threatening diseases and problems shortly.
Hence, it becomes necessary to consult with a professional and come up with medicines that are best suited for you.
What should you do when your blood pressure is 186/82 mmHg during pregnancy?
A blood pressure reading of 186/82 during pregnancy is extremely high and represents a medical emergency that demands immediate hospitalization.
According to a study published in NCBI in 2023 “Preeclampsia. Obstetrical and Gynecological Survey”, this could indicate severe preeclampsia, a pregnancy complication characterized by high blood pressure and potential damage to vital organs like the liver and kidneys, and lead to 500,000 fetal deaths worldwide.
At such elevated levels, the life of both the mother and baby could be at serious risk.
If you find yourself or someone else experiencing this blood pressure range during pregnancy, it is imperative to seek emergency medical attention right away.
Is blood pressure 186/82 mmHg high for a men?
For men, a blood pressure of 186 over 82 mmHg is dangerously high and categorizes as hypertensive crisis. This isn’t just a signal for stage 1 or stage 2 hypertension; it’s an immediate medical emergency.
With blood pressure levels this high, the risk of life-threatening complications such as stroke, heart attack, and organ failure is significantly increased.
Immediate hospitalization is required for prompt treatment and stabilization.
Is blood pressure 186/82 mmHg high for a women?
For women, a blood pressure reading of 186/82 mmHg is equally alarming and constitutes a hypertensive crisis.
This severe elevation in blood pressure poses a grave risk of catastrophic events, such as stroke, kidney failure, and heart attack.
This is an extreme medical emergency that demands urgent hospitalization and aggressive treatment, likely involving intravenous (IV) medications to quickly bring the blood pressure down and close monitoring to avoid organ damage.
Is blood pressure 186/82 mmHg high for an elderly?
For elderly individuals, a blood pressure of 186/82 is extremely dangerous and mandates immediate emergency care.
The elderly are often already at a higher risk for cardiovascular diseases, and a hypertensive crisis could rapidly escalate into life-threatening complications, including organ failure, heart attack, and stroke.
Immediate intervention with medication and close monitoring is crucial.
Is blood pressure 186/82 mmHg high for children?
A blood pressure reading of 186/82 in children is exceptionally high and represents an immediate medical emergency.
In children, blood pressure levels this high could lead to severe organ damage and other catastrophic outcomes.
According to a team of researchers (Cal H. Robinson and Rahul Chanchlani) from The Hospital for Sick Children, Canada, who published in 2022 a report “High Blood Pressure in Children and Adolescents: Current Perspectives and Strategies to Improve Future Kidney and Cardiovascular Health. Kidney International Reports” several factors during the perinatal period are linked to blood pressure in children, such as low birth weight, being born prematurely, and maternal aspects like preeclampsia, blood pressure, age, and BMI.
Emergency medical attention should be sought immediately for diagnosis and treatment, likely including prompt medication to rapidly lower the blood pressure and tests to rule out potential underlying conditions or complications.
Is blood pressure 186 over 82 (186/82) high for an adult?
For an adult, regardless of age or gender, a blood pressure of 186 over 82 mmHg is a severe medical emergency known as a hypertensive crisis.
With levels this high, the individual is at imminent risk for a variety of life-threatening complications like stroke, heart failure, and organ damage.
Emergency medical services should be sought immediately for rapid treatment to lower the blood pressure and to evaluate and manage any organ damage that may be occurring.
FAQ (Frequently Asked Questions)
What is the blood pressure?
What do the numbers on blood pressure readings chart mean?
Based on these pair of numbers, the blood pressure reading is classified into seven stages.
- Very Low Blood Pressure (Severe Hypotension): Below 80/50
- Low Blood Pressure (Hypotension): 80/50 – 90/60
- Normal Blood Pressure: 91/61 – 119/79
- Pre-Hypertension (Elevated Blood Pressure): 120/80 – 139/89
- High Blood Pressure (Stage 1 Hypertension): 140/90 – 159/99
- High Blood Pressure (Stage 2 Hypertension): 160/100 – 180/120
- Hypertensive Crisis: Above 180/120
What is a normal blood pressure?
What is a hypertensive crisis?
A hypertensive crisis is a sudden, severe increase in blood pressure with readings of 180/120 mm Hg or greater.
It is a medical emergency that can lead to life-threatening conditions such as a heart attack, stroke, or other serious health problems. Immediate medical intervention, often involving hospitalization and intravenous medications, is crucial.
This condition can be categorized into two types: hypertensive urgency (without signs of organ damage) and hypertensive emergency (with evidence of organ damage).
What is the difference between hypertensive urgency and hypertensive emergency?
Hypertensive urgency and hypertensive emergency are both critical conditions related to elevated blood pressure, but they differ primarily in the presence of organ damage and the severity of their implications.
No immediate signs of organ damage
Evidence of damage to vital organs like the heart, kidneys, or brain0-80 mmHg
Less pronounced symptoms
Severe symptoms like chest pain, blurred vision, difficulty breathing, or neurological deficits
Immediate medical care is essential
Requires more aggressive interventions
Understanding these differences is crucial for timely and appropriate medical response, emphasizing the importance of regular blood pressure monitoring.
What are the symptoms of a hypertensive crisis?
Symptoms of a hypertensive crisis are characterized by a sudden spike in blood pressure, which can manifest through various symptoms that signal the body’s distress.
Identifying these symptoms is crucial because they signal a possible severe health risk that demands urgent medical care.
- Severe headaches, often described as a pounding sensation in the head.
- Chest pain or tightness, hinting at possible heart strain.
- Shortness of breath, making it challenging to take deep or regular breaths.
- Blurred or double vision, which can be accompanied by nausea.
- Severe anxiety or confusion, reflecting potential neurological effects.
- Nosebleeds that might be spontaneous and difficult to control.
- Irregular heartbeat or palpitations, indicating cardiovascular distress.
The presence of any of these symptoms, especially in combination, should prompt an urgent medical evaluation to prevent complications and ensure appropriate care.
Is a hypertensive crisis life-threatening?
A hypertensive crisis is indeed life-threatening because of the very high blood pressure levels.
When blood pressure shoots up so high, it puts a lot of strain on the walls of our arteries and can hurt important organs in our body.
- This severe condition can lead to heart problems, making the heart struggle to pump blood the right way.
- There’s also a danger of having a stroke, which happens when the brain doesn’t get enough blood. Kidneys, which help get rid of waste from our body, can get damaged too.
- People experiencing this might also face vision problems, and in extreme cases, even go blind. Another serious concern is a tear in the main artery coming out of the heart.
Because of all these potential dangers, it’s crucial to get medical help right away if someone is having a hypertensive crisis.
To avoid getting into such a situation, it’s a good idea to regularly check blood pressure and take any medicines the doctor suggests.
What are the risk factors of a hypertensive crisis?
The risk factors of hypertensive crisis encompass a range of underlying health conditions and lifestyle choices.
Being aware of these risk factors is essential for prevention and early intervention, ensuring better health outcomes.
- Uncontrolled hypertension: Primary precursor where high blood pressure isn’t adequately managed.
- Medication issues: Inconsistent intake, abrupt cessation, or interaction of certain drugs can elevate blood pressure.
- Kidney diseases: These play a role in regulating blood pressure and can be a contributing factor.
- Heart failure: Fluid buildup and increased blood pressure can result from the heart’s inability to pump blood efficiently.
- Stimulant use: Drugs like cocaine or amphetamines can cause significant spikes in blood pressure.
- Endocrine disorders: Conditions like pheochromocytoma or hyperthyroidism can influence blood pressure.
- Vascular conditions: Narrowed or blocked blood vessels can elevate blood pressure levels.
Understanding and managing these risk factors through regular medical check-ups and lifestyle modifications can significantly reduce the chances of experiencing a hypertensive crisis.
What are the causes of hypertensive crisis?
The causes of hypertensive crisis are one of the debated clinical topics, and experts believe a range of things could trigger it .
Identifying and understanding these causes are pivotal for timely intervention and prevention.
- Failure to take prescribed blood pressure medications, leading to uncontrolled hypertension.
- Kidney disease or failure, which plays a role in regulating blood pressure.
- Heart failure, where the heart struggles to pump blood efficiently.
- Interactions with certain medications or drugs, especially stimulants like cocaine.
- Severe infections or inflammatory conditions that affect blood circulation.
- Stroke or brain injuries that impact the nervous system’s regulation of blood pressure.
- Adrenal gland problems, such as tumors or issues with adrenal hormones.
- Being informed about these causes and maintaining regular health check-ups can help in early detection and management, reducing the risk of a hypertensive crisis.
What drugs cause hypertensive crisis?
Drugs that cause hypertensive crisis include both prescription and recreational substances that can elevate blood pressure levels.
Being aware of these medications and substances is crucial to ensure safe usage and prevent potential complications.
- Decongestants: Common in cold and allergy medications, they can narrow blood vessels.
- Non-steroidal anti-inflammatory drugs (NSAIDs): Like ibuprofen, they can cause fluid retention.
- Birth control pills: Hormonal changes can influence blood pressure.
- Antidepressants: Especially monoamine oxidase inhibitors (MAOIs).
- Stimulants: Such as cocaine or amphetamines, which increase heart rate and blood vessel constriction.
- Certain herbal supplements: Like ephedra, which can elevate blood pressure.
- Corticosteroids: Used for inflammation, they can cause water and salt retention.
How is a hypertensive crisis diagnosed?
Diagnosing a hypertensive crisis involves a series of evaluations and tests to confirm the sudden surge in blood pressure and assess any potential damage to vital organs.
- First, they measure the patient’s blood pressure with a tool called a sphygmomanometer. It’s common to take multiple readings to make sure the high numbers aren’t just a one-time thing.
- They also take blood samples to see if any important organs, like the heart or kidneys, are damaged.
- An electrocardiogram, or ECG, is used to watch how the heart is working and find any unusual patterns.
- They might also check the patient’s urine to see how the kidneys are doing, and even take a look at the eyes to see if the small blood vessels there are damaged.
- Beyond these tests, the doctor will ask about the patient’s past health issues, medications, and current symptoms.
All of this information helps them figure out the best way to treat the crisis quickly and effectively.
How to take blood pressure at home?
Taking blood pressure at home is a straightforward process with the right equipment and technique.
- Acquire a digital blood pressure monitor from a reputable brand.
- Sit comfortably in a quiet room, resting for about five minutes before taking a reading.
- Place the cuff on the upper arm, ensuring it’s neither too tight nor too loose.
- Keep the arm at heart level, resting it on a table or armrest.
- Turn on the monitor and follow the device’s instructions to start the measurement.
- Remain still and silent during the process.
- Record the reading, noting both the systolic (top number) and diastolic (bottom number) values.
Which is the best and accurate blood pressure monitor to use at home?
Finding the best and accurate blood pressure monitor for home use in today’s internet market flooded with technology is a challenging task.
While you may find cheap options online, the reproducibility of results is a big question mark. This could sometimes mean life or death, and that’s why you need a clinically valid product that is no less than smart!
The three best recommendations from the internet are below.
What are the treatments for hypertensive crisis?
The treatments for hypertensive crisis involve immediate and targeted interventions to rapidly reduce elevated blood pressure and prevent potential damage to vital organs.
How doctors choose to treat this depends on how bad the situation is and if there are other health problems happening at the same time. Often, the person needs to be in the hospital so doctors can watch them closely.
They usually get medicine directly into their veins, using drugs like nitroprusside or labetalol, which work fast to lower blood pressure.
To make sure the treatment is working and the blood pressure is not too high or too low, it’s checked continuously. Doctors might also do more tests, like heart tracings, blood tests, or pictures of the inside of the body, especially if they think some organs might be hurt.
Once things are more stable, the person might get pills to help keep their blood pressure at a safe level.
After this, they might be advised to make some changes in their life, like eating differently or finding ways to relax. It’s super important to catch this early and follow doctor’s orders to get better and stay healthy in the future.
What medications are used to treat hypertensive crisis?
Medications used to treat hypertensive crisis are administered to rapidly decrease elevated blood pressure levels and prevent potential complications, ensuring the safety and well-being of the patient. Some of the common drugs can be found below.
- Nitroprusside: A potent vasodilator, it’s given intravenously to quickly reduce blood pressure.
- Labetalol: An IV beta-blocker, it helps in lowering blood pressure without reducing heart rate significantly.
- Nicardipine: A calcium channel blocker, it relaxes blood vessels, promoting smoother blood flow.
- Esmolol: Another beta-blocker, it’s effective for short-term blood pressure control.
- Hydralazine: A vasodilator, it’s used when other medications might not be suitable.
- Furosemide: A diuretic, it helps reduce fluid buildup, aiding in blood pressure control.
The choice of medication often depends on the patient’s overall health, the severity of the crisis, and any underlying conditions. Regular follow-up and medication adherence are essential for continued health management.
Can hypertensive crisis be treated at home?
A hypertensive crisis is very serious and cannot be treated at home. It can cause damage to vital organs and lead to life-threatening situations.
Even though you might be tempted to use over-the-counter medications or home remedies, they aren’t enough to handle the extremely high blood pressure levels in such a crisis.
If you suspect a hypertensive crisis, you must get medical help right away. Waiting too long without proper medical care can cause lasting damage to your organs or could even be fatal.
After getting treated by medical professionals, they might provide you with advice on how to monitor and handle your blood pressure at home in the future.
It’s essential to follow their guidance, take any prescribed medications, and make necessary lifestyle changes to stay healthy and prevent another crisis.
What are the complications of hypertensive crisis?
Complications of hypertensive crisis refer to the severe health issues that can arise when blood pressure reaches alarmingly high levels.
A hypertensive crisis is not just an isolated concern; it can lead to a cascade of problems affecting multiple organ systems.
Some of the complications are listed below.
- Heart failure: The heart struggles to pump blood efficiently, leading to fluid buildup.
- Stroke: Reduced blood flow to the brain or bleeding can cause a stroke.
- Kidney damage: Elevated blood pressure can impair kidney function, affecting waste elimination.
- Vision loss: Blood vessel damage in the eyes can lead to blurred vision or blindness.
- Aortic dissection: A tear in the heart’s main artery can be life-threatening.
- Pulmonary edema: Buildup of fluids in the lungs can cause breathing difficulties.
Recognizing the signs of a hypertensive crisis and seeking timely medical care can help prevent these complications and ensure better health outcomes.
How to prevent a hypertensive crisis?
Preventing a hypertensive crisis involves proactive measures to manage and control blood pressure levels. Adopting a heart-healthy lifestyle and staying vigilant about one’s health can significantly reduce the risk of facing this severe condition.
- Regular monitoring: Check blood pressure routinely, either at home or in a clinical setting.
- Medication adherence: Take prescribed antihypertensive drugs consistently and consult a doctor before making any changes.
- Dietary choices: Opt for a balanced diet, limiting salt intake and incorporating potassium-rich foods.
- Physical activity: Routine and regular exercise can help you maintain cardiovascular health.
- Limit stimulants: Avoid excessive caffeine and refrain from using recreational drugs.
- Stress management: Incorporate relaxation techniques like meditation or deep breathing exercises.
- Regular doctor check-ups: Visit a healthcare professional periodically to assess cardiovascular health and make necessary adjustments.
By staying informed and proactive, one can effectively mitigate the risks associated with a hypertensive crisis.