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Alternative names Return to top
Accelerated hypertension; Arteriolar nephrosclerosis; Nephrosclerosis - arteriolar; Hypertension - malignantDefinition Return to top
Malignant hypertension is usually defined as very high blood pressure with swelling of the optic nerve behind the eye, called papilledema (grade IV Keith-Wagner hypertensive retinopathy). Malignant hypertension is usually accompanied by other organ damage like heart failure, kidney failure, and hypertensive encephalopathy.Causes, incidence, and risk factors Return to top
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 women with toxemia of pregnancy, and people with kidney disorders or collagen vascular disorders. You are at high risk for malignant hypertension if you have had kidney (renal) failure or renal hypertension caused by renal artery stenosis.
Malignant hypertension is a medical emergency. Many body systems are in serious risk due to the extreme elevation of blood pressure. Multiple organs of the body, including the brain, eyes, blood vessels, heart, and kidneys may sustain damage. The blood vessels of the kidney are highly susceptible to damage caused by pressure, and kidney failure may develop, which may be permanent.
Symptoms Return to top
Signs and tests Return to top
Your blood pressure may be extremely high. An eye examination will reveal changes that indicate high blood pressure, including papilledema (swelling of the optic nerve), retinal bleeding, or infarction (cotton wool spots or soft exudate -- fluid with cellular debris) in the retina. If not already present, kidney failure may develop as a complication of malignant hypertension. Other complications may also develop.Treatment Return to top
Hospitalization is essential until the severe high blood pressure is under control. Medications delivered through an IV line, such as nitroprusside, nitroglycerin, or others, may reduce your blood pressure.Expectations (prognosis) Return to top
If treated promptly, malignant hypertension is often controlled without permanent complications. If it is not treated promptly, complications may be severe and life-threatening.Complications Return to top
Calling your health care provider Return to top
Go to the emergency room or call your local emergency number (such as 911) if symptoms of malignant hypertension develop. This is an emergency condition!
Call your health care provider if you know you have poorly controlled high blood pressure.
Prevention Return to top
If you have high blood pressure, carefully monitoring your blood pressure and taking your medicines properly help to reduce the risk. Update Date: 10/29/2003 Updated by: Irfan A. Agha, M.D., Department of Medicine, Renal Division, St. Louis University, St. Louis, MO. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |