Malignant hypertension is very
Accelerated hypertension; Arteriolar nephrosclerosis; Nephrosclerosis – arteriolar; Hypertension – malignant; High blood pressure – malignant
The disorder affects about 1% of people with high blood pressure, including both children and adults. It is more common in younger adults, especially African-American men.
It also occurs in people with:
Collagen vascular disorders (such as systemic lupus erythematosus, systemic sclerosis,and periarteritis nodosa)
Toxemia of pregnancy
You are at high risk for malignant hypertension if you have had:
Renal hypertensioncaused by renal artery stenosis
Change in mental status, such as:
decreased alertness, decreased ability to concentrate, fatigue, restlessness, sleepiness, stupor, lethargy Chest pain(feeling of crushing or pressure) Cough Headache Nausea or vomiting Numbnessof the arms, legs, face, or other areas Reduced urineoutput Seizure Shortness of breath Weaknessof the arms, legs, face, or other areas
Exams and Tests
Malignant hypertension is a medical emergency.
A physical exam commonly shows:
Extremely high blood pressure
Swelling in the lower legs and feet
Abnormal heart sounds and fluid in the lungs
Changes in thinking, sensation, muscle ability, and reflexes
An eye examination will reveal changes that indicate high blood pressure, including:
Bleeding of the retina (back part of the eye)
Narrowing of the blood vessels in the retina
Swelling of the optic nerve
Other problems with the
Kidney failure, as well as other complications, may develop.
Tests to determine damage to the kidneys may include:
Arterial blood gas analysis
BUN Creatinine Urinalysis
This disease may also affect the results of the following tests:
- Cardiac enzymes (markers of heart damage)
CT scan of the brain Electrocardiogram(EKG)
You will need to stay in the hospital until the severe high blood pressure is under control. Medications will be given through a vein to reduce your blood pressure.
If there is fluid in your lungs, you will be given medicines called diuretics, which help the body remove fluid. Your doctor will consider giving you medications to protect the heart if there is evidence of heart damage.
After the severe high blood pressure is brought under control, blood pressure medicines taken by mouth can control blood pressure. Your medication may need to be changed sometimes. High blood pressure can be difficult to control.
Many body systems are at serious risk from the extreme rise in blood pressure. Many organs, including the brain, eyes, blood vessels, heart, and kidneys may be damaged.
The blood vessels of the kidney are very likely to be damaged by pressure. Kidney failure may develop, which may be permanent and need
If treated right away, malignant hypertension can often be controlled without causing permanent problems. If it is not treated right away, complications may be severe and life-threatening.
- Brain damage (stroke, seizures)
- Heart damage, including:
angina(chest pain due to narrowed blood vessels or weakened heart muscle), heart rhythm disturbances
- Kidney failure
- Permanent blindness
Pulmonary edema(fluid in the lungs)
When to Contact a Medical Professional
Go to the emergency room or call your local emergency number (such as 911) if you have symptoms of malignant hypertension. This is an emergency condition and it can be life-threatening.
Call your health care provider if you know you have poorly controlled high blood pressure.
If you have high blood pressure, carefully monitor your blood pressure and take your medicines properly to help reduce the risk. Eat a healthy diet that is low in salt and fat.