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In hypertensive encephalopathy, generally the blood pressure is greater than 200/130 mmHg. [1] Occasionally it can occur at a BP as low as 160/100 mmHg. [4] This can occur in kidney failure, those who rapidly stop blood pressure medication, pheochromocytoma, and people on a monoamine oxidase inhibitor (MAOI) who eat foods with tyramine. [2]
In the absence of hydrostatic effects (e.g. standing), mean blood pressure decreases as the circulating blood moves away from the heart through arteries and capillaries due to viscous losses of energy. Mean blood pressure drops over the whole circulation, although most of the fall occurs along the small arteries and arterioles. [75]
For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit [6] [16] [17] and others finding unclear benefit. [18] [19] [20] High blood pressure affects 33% of the population globally. [9] About half of all people with high blood pressure do not know that they have it. [9]
Blood pressure targets [7] <1 hr 25% reduction in the mean arterial pressure, diastolic blood pressure above 100 2-6 hr Systolic BP < 160 mmHg or Diastolic BP <110 mmHg 6-24 hr monitor BP targets, ensure non-rapid drop in BPs below 160 SBP or 100 DBP 1-2 d if no end-organ damage, monitor out-patient and JNC8 Guidelines for maintaining BP control
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Labile hypertension occurs when there are unexpected changes in blood pressure.The term can be used to describe when people have blood pressure measurements that abruptly fluctuate from being abnormally high, approximately 140/90mm Hg or over and returns to its normal range.