When is blood pressure an emergency?
On this page
With chest pain, shortness of breath, back pain, weakness, numbness, vision change or trouble speaking, call emergency services now, whatever the number. If your systolic (the top number) is 180 or higher, or your diastolic (the bottom number) is 120 or higher, and you have no symptoms, wait a minute and measure again. If it stays that high, call your doctor now.
What to do
| What you have | What to do |
|---|---|
| Any of the symptoms above, at any number | Call emergency services. Don’t wait to see if it comes down. |
| Systolic 180 or higher, or diastolic 120 or higher, with no symptoms | Wait at least 1 minute and measure again. |
| Still that high on the second try, no symptoms | Contact your doctor right away, the same day. |
| Symptoms start at any point | Call emergency services. |
| Second try is lower, no symptoms | Tell your doctor at the next chance and take a home week. |
| A home average of 140/90 or higher, no symptoms | Book a doctor’s visit. |
In the US, emergency services means 911.
Pregnant or recently gave birth
The cutoffs are lower in pregnancy. A systolic of 160 or higher, or a diastolic of 110 or higher, is the severe range, and guidelines treat it as urgent. Call your care team or go in right away. A headache that won’t go away, vision changes, or pain in the upper belly or shoulder also needs care right away. Preeclampsia can also start after delivery, usually between 48 hours and six weeks later, so the same signs need care then too.
Why the symptoms come first
The American Heart Association splits very high numbers into two cases. If you have symptoms that suggest damage to the heart, brain, kidneys or eyes, it calls this a hypertensive emergency, and it’s treated in a hospital. Without those symptoms, the 2025 US guideline calls it severe hypertension, and the next step is to call your clinician.
You can’t tell the two apart from the number alone. Someone with chest pain at 150/90 should still call, and someone who feels fine at 185/115 should measure again first.
Check the setup, once
A high first number can come partly from how you measured. Before the second try, sit down, stop talking and rest your arm on a table at heart height. A cuff result can run high if you had coffee, smoked or exercised in the 30 minutes before, or if your bladder is full. If the second number is still that high after you fix those things, you still call your doctor the same day.
What not to do
Don’t take an extra dose of a medication, or skip one, to get the number where you want it. Ask the clinician who prescribes it. Don’t drive yourself if you have symptoms. Call emergency services instead.
6 sources
- American Heart Association, When To Call 911 About High Blood Pressure, checked 2026heart.org
- American Heart Association, Home Blood Pressure Monitoring, checked 2026heart.org
- Brown C, Clark D, Jones DW, Updates in the 2025 AHA/ACC Hypertension Guideline, Current Hypertension Reports, 2026pmc.ncbi.nlm.nih.gov
- American College of Obstetricians and Gynecologists, Preeclampsia and High Blood Pressure During Pregnancy, checked 2026acog.org
- NICHD, Preeclampsia and Eclampsia fact sheet, checked 2026nichd.nih.gov
- American Heart Association, Toolbox Talks, Blood Pressure, preparing to measure, checked 2026heart.org
