I guess we could argue at what point it is no longer physically possible to be asymptomatic with an extremely high blood pressure, but to date there is no evidence to support the treatment of the blood pressure number alone in the acute setting.
Low blood pressure is a separate issue, but also only really treated if causing issues for a patient; however similarly, one questions the plausibility that a patient could be properly perfusing their organs and therefore have no other signs/symptoms of organ damage with a mean arterial pressure of ~30 mm Hg.
I think once I got near that level post dialysis and had no symptoms…
Until the moment I stood up. Then it was all the symptoms.
Likewise, I haven’t have 300/200, but did have 200+/150+, and didn’t have symptoms… Until I went to try to sleep for the night.
That’s the issue with your premise. It’s reactionary treatment rather than preventative, and from personal experience preventative is much more pleasant.
But I suppose in the USA the standard for example is reactionary treatment due to healthcare only being private and the insurance companies not wanting to pay up.
I know of that, but that’s usually after a quick check up and checking both arms plus pulse. Because if a person usually doesn’t have that high of a pressure and hasn’t gone through any excitatory activity, then they’re at risk of stroke or cardiac failure, especially if the pressures vary between arms by over 25 points. It’s the stroke and cardiac failure risk why high blood pressure is in part called the silent killer - you can live asymptomatically but then the long term effects can get you (more so if the case is extreme).
In which case, you’d want to be able to quickly administer some kind of fast acting medication (usually injected to lower it), which a person can’t do at home, and then monitor them for awhile before prescribing them a standard high blood pressure medication and a follow up with a general doctor, and depending on future results then do more tests like an ultrasound.
Asymptomatic doesn’t mean things are okay. There’s many diseases that are asymptomatic or at least not overtly symptomatic (as in, the patient can’t tell they actually have a symptom until after it’s been treated and they then notice the difference) but ideally you’d actually treat them before they’re symptomatic. Circulatory problems being one of them. Another being hyper cancers and certain organ failures like kidney and liver failure.
I guess we could argue at what point it is no longer physically possible to be asymptomatic with an extremely high blood pressure, but to date there is no evidence to support the treatment of the blood pressure number alone in the acute setting.
Low blood pressure is a separate issue, but also only really treated if causing issues for a patient; however similarly, one questions the plausibility that a patient could be properly perfusing their organs and therefore have no other signs/symptoms of organ damage with a mean arterial pressure of ~30 mm Hg.
I think once I got near that level post dialysis and had no symptoms…
Until the moment I stood up. Then it was all the symptoms.
Likewise, I haven’t have 300/200, but did have 200+/150+, and didn’t have symptoms… Until I went to try to sleep for the night.
That’s the issue with your premise. It’s reactionary treatment rather than preventative, and from personal experience preventative is much more pleasant.
But I suppose in the USA the standard for example is reactionary treatment due to healthcare only being private and the insurance companies not wanting to pay up.
I know it feels wrong, but the data supports outpatient management of asymptomatic high blood pressure.
And the European Society of Cardiology agrees with the AHA, so it’s not just an American thing. Check out section 10, or ctrl+F “hypertensive urgency”.
I know of that, but that’s usually after a quick check up and checking both arms plus pulse. Because if a person usually doesn’t have that high of a pressure and hasn’t gone through any excitatory activity, then they’re at risk of stroke or cardiac failure, especially if the pressures vary between arms by over 25 points. It’s the stroke and cardiac failure risk why high blood pressure is in part called the silent killer - you can live asymptomatically but then the long term effects can get you (more so if the case is extreme).
In which case, you’d want to be able to quickly administer some kind of fast acting medication (usually injected to lower it), which a person can’t do at home, and then monitor them for awhile before prescribing them a standard high blood pressure medication and a follow up with a general doctor, and depending on future results then do more tests like an ultrasound.
Asymptomatic doesn’t mean things are okay. There’s many diseases that are asymptomatic or at least not overtly symptomatic (as in, the patient can’t tell they actually have a symptom until after it’s been treated and they then notice the difference) but ideally you’d actually treat them before they’re symptomatic. Circulatory problems being one of them. Another being hyper cancers and certain organ failures like kidney and liver failure.