From the Guidelines
There are no safe over-the-counter supplements or medications that can quickly lower dangerously high blood pressure, and patients with severe hypertension should seek immediate medical attention at an emergency room. This is because severe hypertension can lead to life-threatening complications such as stroke or heart attack, and only prescription medications administered under medical supervision can safely and effectively lower blood pressure from such extreme levels 1.
Key Considerations
- Severe hypertension is defined as a blood pressure greater than 180/120 mmHg, and it requires immediate medical attention to prevent target organ damage 2.
- The American College of Cardiology and American Heart Association guidelines recommend against using oral therapy for hypertensive emergencies, and instead suggest intravenous therapy to lower blood pressure quickly and safely 2.
- The European Society of Cardiology guidelines recommend careful acute blood pressure lowering with intravenous therapy to less than 180 mmHg in patients with systolic blood pressure greater than or equal to 220 mmHg 1.
Management of Severe Hypertension
- Patients with severe hypertension should be treated with prescription medications such as intravenous labetalol, oral methyldopa, or nifedipine, under the supervision of a medical professional 1.
- Intravenous hydralazine is a second-line option for treating severe hypertension 1.
- Lifestyle changes such as reducing sodium, exercising, and managing stress can help lower blood pressure over time, but they will not address the acute crisis of severe hypertension.
Importance of Seeking Medical Attention
- Delaying treatment for severe hypertension can result in severe organ damage or death, and no home remedy or supplement can substitute for urgent medical intervention in this situation 2, 1.
- Patients with severe hypertension should call 911 or have someone drive them to the nearest emergency room without delay, as prompt medical attention is essential to preventing life-threatening complications.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Over-the-Counter Options for Severe Hypertension
There are no over-the-counter (OTC) options specifically recommended for lowering severe hypertension.
Management of Asymptomatic Severe Hypertension
- Management of asymptomatic severe hypertension typically starts with long-acting antihypertensive drugs, such as:
- Renin-angiotensin system inhibitors
- Thiazide diuretics
- Calcium channel blockers 3
- Patients with severely elevated blood pressure but without symptoms of acute target organ injury can often be managed in the outpatient setting 4
- Aggressive lowering of blood pressure should be avoided, and the use of parenteral medications is not indicated for asymptomatic severe hypertension 4
Treatment of Severe Hypertension
- Current recommendations are to gradually reduce blood pressure over several days to weeks 4
- Oral antihypertensives may be administered to patients with severely elevated blood pressure, especially those with blood pressure-related complaints or patient-suspected severely elevated blood pressure 5
- Intravenous antihypertensives are typically reserved for patients with severe hypertension and symptoms of acute target organ injury, such as chest pain 5
Important Considerations
- Patients with escalating blood pressure, manifestation of acute target organ injury, or lack of compliance with treatment should be considered for hospital admission 4
- The optimal assessment and management of patients with severely elevated blood pressure require careful consideration of their individual clinical presentation and risk factors 6, 7