Can injections be given to a person with hypertension?

Administering Injections in a Patient with Blood Pressure of 160/90 mmHg

Injections can be safely administered to a person with a blood pressure of 160/90 mmHg as this blood pressure level does not constitute a contraindication for most injectable medications. 1

Blood Pressure Classification and Injection Safety

According to the 2017 ACC/AHA guidelines, a blood pressure of 160/90 mmHg is classified as Stage 2 hypertension 2. However, this level does not reach the threshold that would prohibit most injectable medications.

Key considerations for injection administration:

• For most routine injections: BP of 160/90 mmHg is not a contraindication 2
• For bevacizumab therapy: BP should be <160/100 mmHg to proceed with administration 2
• For thrombolytic therapy: BP must be <185/110 mmHg before administration 2

Special Considerations by Injection Type

Emergency Medications

• Epinephrine: Can be administered for anaphylaxis even with elevated BP, as the risk of untreated anaphylaxis outweighs the risk of temporary BP elevation 2
• Vasopressors: Should be used with caution but are not contraindicated at this BP level 2

Non-Emergency Medications

• Antihypertensives: Can be administered to help lower the blood pressure 2
• Routine vaccinations: No contraindication at this BP level 1
• Insulin and other chronic medications: Can be administered without special precautions 1

Precautions When Administering Injections

1. Monitor blood pressure before and after administration of medications known to affect BP 1
2. Observe for 15-30 minutes after administration of medications that might cause hypotension 1
3. Consider oral medications when appropriate instead of injectable forms for non-urgent situations 1

When to Delay Injections

Injections should be delayed or reconsidered in the following circumstances:

• Hypertensive emergency: BP >180/120 mmHg with evidence of acute target organ damage 2
• Pre-thrombolytic therapy: If BP >185/110 mmHg and planning thrombolytic administration 2
• Specific medication contraindications: Some medications have specific BP thresholds (refer to medication-specific guidelines) 2

Management of Hypertension Before Elective Injections

For patients with elevated BP who need non-urgent injections:

1. Consider treating the hypertension first if BP ≥180/110 mmHg 2
2. For BP between 160/90 and 180/110 mmHg without end-organ damage, most injections can proceed 1
3. Document BP readings before and after injection 1

Conclusion

A blood pressure of 160/90 mmHg alone is not a contraindication for most injectable medications. However, the specific type of injection, underlying medical conditions, and the urgency of treatment should be considered in the decision-making process. When in doubt about a specific medication, consult the medication's prescribing information for any BP-related contraindications.