What’s in your kit
Eight tools. The first three are the rules you must know cold — they decide when something is an emergency. The rest keep the daily partnership steady and tell you where your role begins and ends.
1 · The 180/120 Rule
Know this coldA single high reading is common and rarely dangerous on its own. But a reading at or above 180/120 PLUS symptoms is a hypertensive emergency — treat it like a heart attack or stroke.
HTN HYPERTENSIVE EMERGENCY RULE
Patient card2 · The Daily Log Rule
Know this coldThe single biggest cause of unstable BP is missing the home log. Office readings catch one moment; the home log shows the team what is really happening 28 readings at a time.
HTN HOME-READING RULE
Patient card3 · Other Red Flags — Emergencies
Know this coldBeyond the two red rules above, these situations also mean immediate help. When in doubt, the home care plan handles ordinary days — these are not ordinary.
🧠 Stroke signs
Sudden face droop, arm weakness, slurred speech, sudden severe headache, vision change, or confusion. BE-FAST. Time matters — tPA window is 4.5 hours from onset.
Call 911 now❤️ Chest pain
New chest pressure, tightness, or pain — especially with sweating, shortness of breath, nausea, or pain radiating to arm or jaw. Could be a heart attack.
Call 911 now👀 Vision change + high BP
Sudden blurred or lost vision with a high BP reading. Can be a hypertensive emergency causing brain swelling. Do not wait.
ED now💨 Severe shortness of breath
New or sudden breathlessness, especially at rest or lying down. Can be heart failure brought on by uncontrolled BP.
ED now4 · The Contact Ladder
Fill in & printWhen something is wrong, you should not be deciding who to call in the moment — only which rung you are on. Fill in the names and numbers now, while things are calm.
You's written BP action plan
Most days start here: confirm the home medicines were taken, recheck the BP after 5 minutes if a reading looked off, log it. The plan tells you when to climb to the next rung.
Action plan kept: ________________________PCP nurse line or cardiology
For guidance — persistent high readings, medication side effects, "should we come in?" Many practices have a nurse line that adjusts BP medicines by phone. This is your most valuable everyday number.
Specialty team: ________________________Primary care provider
For routine visits, refills, screening, and non-BP problems. Useful — but for BP emergencies, go to Rung 2 or 4, not here.
Primary care: ________________________911 / Emergency Department
For 180/120 with symptoms, stroke signs, chest pain, severe shortness of breath, vision loss. Note: 180/120 WITHOUT symptoms goes to urgent care, not the ED.
Preferred ED: ________________________5 · Home Blood-Pressure Log
Tap to logLog the higher of two morning readings in the morning slot, and the higher of two evening readings in the evening slot. Enter the top (systolic) number only here; track the bottom number in your notebook or app for the full log to bring to visits.
Target for most adults: under 130/80. Discuss your personal target with their team. Bring the full numeric log (with bottom numbers) to every appointment.
6 · BP Medication Support
Daily routineMost patients need 2-3 BP medicines to hit goal — that is normal, not a failure. The single biggest reason BP medicines seem to "not work" is missed doses.
Pair with a habit
Take the morning dose with breakfast or right after brushing teeth. The brain remembers stacked habits.
Watch for dizziness
New dizziness on standing — especially in the first 2 weeks of a new medicine — means tell the team. They can adjust dose or switch.
Side effects, not stopping
If a side effect bothers you (dry cough on ACE, leg swelling on amlodipine), call the team. Almost any side effect has an alternative medicine.
Never stop suddenly
Stopping a BP medicine cold — especially a beta-blocker — can cause a rebound spike or rhythm problem. Always taper with the team.
7 · The ER Go-Bag
Pack once, check monthlyA crisis is not the time to gather paperwork. Pack a go-bag now and keep it by the door. Tap each item as you add it — your checklist saves on this device.
8 · Speak Up / Trust the Team Guide
You boundaryThe hardest skill in patienting is knowing when to act and when to hold back. A great patient is a reliable backup and a fierce advocate — without taking your own care away from them.
💬 Speak up when…
- A red-flag rule is met and a clinician is dismissing it — restate the rule and the home plan calmly and clearly.
- You are in the ED and your home plan is being ignored — ask for it to be looked at, and ask for a senior clinician if needed.
- You are about to be given a medicine or test that wasn’t in the plan — ask why, and ask about alternatives.
- Your symptoms are escalating between visits — call before it becomes an ER trip.
- You feel unheard or rushed — it’s OK to say "I need a minute to ask one more question."
🤝 Trust the team when…
- They have proposed a guideline-based treatment that fits your plan.
- You disagree from fear rather than from new information — pause, ask one question, listen.
- You are on a stable run that’s working — small adjustments often beat big changes.
- Your care partner’s instinct and the team’s recommendation agree — that’s a strong signal.
- You’ve done your part of the homework — logs, questions, honest history — and now it’s the team’s turn.