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Hypertension and Headache


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


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


  • 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


  • 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.

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