Malignant hypertension is blood pressure that is so high that it is actually causing damage to organs, particularly in the nervous system, the cardiovascular system, and/or the kidneys. One type of such damage is called papilledema, a condition in which the optic nerve leading to the eye becomes dangerously swollen, threatening vision.
This is a serious condition that requires immediate care from your doctor. Rapid treatment can prevent long-term problems. Left untreated, damage from malignant hypertension occurs quickly and can be severe, involving organ damage to blood vessels, the eyes, heart, spleen, kidneys, and brain. In particular,
may develop since the blood vessels inside the kidneys are very sensitive to high blood pressure.
Renal artery stenosis or narrowing of the arteries to the kidneys
Missing doses of prescribed antihypertensive medications, particularly beta-blockers or clonidine (Catapres), which can cause a rebound effect. Medication noncompliance is the most common reason for hypertensive emergencies.
A risk factor is something that increases your chance of getting a disease or condition. You are more likely to develop malignant hypertension if you have already have essential hypertension—high blood pressure of 140/90 or higher. Your risk may increase further if you are:
In particular, malignant hypertension can lead to a condition called hypertensive encephalopathy. Symptoms of this condition include:
headache, vomiting, blurry vision with papilledema, mental changes like
, confusion, fatigue, and seizure.
If you experience any of the above symptoms, do not assume it is due to malignant hypertension. These symptoms may be caused by other health conditions, including a
or other less serious disorders. If you experience any one of them, see your physician.
Your doctor will ask about your symptoms and medical history, and perform a physical exam. Your blood pressure readings will probably be very high. Readings will be taken in both arms, while lying down and while standing up. A careful stethoscope exam of your heart and a detailed neurological exam will be performed. An eye exam may show signs of high blood pressure, including swelling of the optic nerve or bleeding inside the eye.
Tests may include the following:
Blood tests for BUN and creatinine levels to check for kidney damage
Renal duplex or
test of the kidney's arteries to look for blockage
Since malignant hypertension is a medical emergency, treatment needs to be received quickly. Treatment options include the following:
Intravenous high blood pressure medications–The specific medication will be chosen based on your specific situation, including whether you are suffering from damage to your kidneys or other organs. Possible medications may include:
Sodium nitroprusside or nitroglycerin
Vasotec (enalapril) and ACE-inhibitor
Oral high blood pressure medicines once blood pressure has been lowered from dangerous levels
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a