Define Malignant Hypertension

Malignant hypertension is a very serious condition in which the blood pressure is very high and requires emergency treatment. The blood pressure is so high that it is starts to damage organs such as the kidneys or the cardiovascular system.

Causes

• People with high blood pressure, kidney failure or hypertension related to the kidneys are at a higher risk of developing this disease; younger adults, black males and women with toxemia of pregnancy are at risk as well.

Common Symptoms

• Common symptoms of malignant hypertension include blurry vision, dizziness, headache and irritability. Upon examination, the optic nerve in the eye is often blurry and swollen because of the increased blood pressure.

Less Common Symptoms

• Nosebleeds, heart palpitations, vomiting and leg edema (swelling) can also be symptoms of malignant hypertension.

Signs of Worsening Symptoms

• Difficulty breathing along with chest pain, vision loss, numbness of a limb or loss of function of a limb are signs the malignant hypertension is getting worse. In other words, the blood pressure has not gone down and might have increased.

Evaluation

• There is urgency to the treatment of this condition. The patient will end up staying in the hospital for a few days to investigate with kidney tests, EKG, chest X-rays and perhaps CTs of the head to determine if there is any long-term damage.

Treatment

• Multiple classes of antihypertensive medications (calcium channel blockers, beta blockers, alpha beta blockers and vasodilating agents) can be used to treat malignant hypertension. The goal is to get the blood pressure lowered as quick as possible but in a safe manner.