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What Is Considered Stroke-Level High Blood Pressure?

high blood pressure
Blood pressure readings above 180/120 mmHg are considered stroke-level and dangerously high

A severe increase in blood pressure that can lead to a stroke is called a hypertensive crisis. Extremely high blood pressure can damage blood vessels and weaken arteries in the brain, increasing the risk of stroke.

High blood pressure, or hypertension, is the leading cause of strokes in the U.S. However, understanding risk factors and blood pressure readings can help people seek appropriate treatment:

  • Healthy blood pressure: under 120/80 mm Hg
  • Prehypertension: 120/80 mm Hg to 139/89 mm Hg
  • Hypertension: above 140/90 mm Hg
  • Hypertensive crisis: above 180/120 mm Hg

Blood pressure readings above 180/120 mmHg are considered stroke-level, dangerously high and require immediate medical attention.

What are symptoms of high blood pressure?

While hypertension is sometimes called the silent killer due to the fact that most people show no symptoms, a few common signs of the condition include: 

Rare symptoms may include:

What are the different types of hypertension?

There are two types of hypertension:

  • Primary hypertension or essential hypertension is the most common type, and there is no known cause for it. This type of high blood pressure usually takes many years to develop is often the result of lifestyle, environment and older age.
  • Secondary hypertension is caused by another health problem or medication:
    • Kidney problems
    • Sleep apnea
    • Thyroid or adrenal gland problems
    • Side effects of some medications

What are treatment options for high blood pressure?

Treating high blood pressure may include a combined approach of dietary changes, medication and exercise. The goal is to lower your blood pressure and thus lower your risk of developing health problems caused by high blood pressure. 


If your blood pressure is between 120/80 mm Hg and 130/80 mm Hg, your doctor may recommend lifestyle changes like losing weight or quitting smoking to help bring blood pressure down to a normal range. Medication is rarely used at this stage.

Stage I hypertension

If your blood pressure is above 130/80 mmHg but below 140/90 mmHg, your doctor may prescribe a blood pressure medication in addition to recommending lifestyle changes.

Stage II hypertension

If your blood pressure is above 140/90 mmHg, your doctor may start you on more rigorous medications and recommend stricter lifestyle changes. Medications may include:

  • Diuretics or water pills help kidneys remove some salt (sodium) from the body. As a result, blood vessels do not have to hold as much fluid and normal blood pressure can be maintained.
  • Beta-blockers lower stress on the heart and blood vessels.
  • Angiotensin-converting enzyme inhibitors (also called ACE inhibitors) help relax blood vessels and lower blood pressure as a result.
  • Angiotensin II receptor blockers (also called ARBs) work the same way as angiotensin-converting enzyme inhibitors.
  • Calcium channel blockers relax blood vessels by reducing the amount of calcium entering cells.
  • Alpha-blockers help relax blood vessels and lower blood pressure as a result.
  • Centrally acting drugs send signals to the brain and nervous systems to relax blood vessels.
  • Vasodilators help muscles in the walls of blood vessels to relax.
  • Renin inhibitors are a new type of medication that reduces the amount of angiotensin precursors, relaxing blood vessels.

Possible side effects

Common side effects of high blood pressure medicines include:

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