Hypertension and Headache

Introduction

Pain will cause hypertension. Beware the headache which causes this and exclude your red flag diagnoses. Hypertension can cause headache and other end organ damage.

• Defined as SBP >215 mmHg, DBP >125 mmHg, with symptoms

• Repeat blood pressure manually to guarantee correct reading

Assessment

• Core of the assessment is ruling out other red flag causes, therefore your assessment will follow down those lines

Management

• Primary survey, ABCDE approach and immediate resuscitation in systems, including oxygen, IV analgesia and fluids

• Lower SBP no more than 25%, usually with vasodilators

• Seek senior ED advice early

Disposition

• Depending on any underlying pathology

• If there is no serious pathology and HT and symptoms are resolved, it may be appropriate to discharge home if:

  • the likely cause is addressed, (i.e. anti HT medication); and

  • social circumstances, including adequate follow up, are defined and organised.