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Malignant hypertension is a sudden and rapid development of extremely high blood pressure. The lower (diastolic) blood pressure reading, which is normally around 80 mmHg, is often above 130 mmHg.
Alternative NamesAccelerated hypertension; Arteriolar nephrosclerosis; Nephrosclerosis - arteriolar; Hypertension - malignant; High blood pressure - malignant
Causes, incidence, and risk factorsThe 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 persons with kidney disorders or collagen vascular disorders.
You are at high risk for malignant hypertension if you have had kidney failure or renal hypertension caused by renal artery stenosis.
Symptoms- Abnormal sensation (numbness) of the arms, legs, face, or other areas
- Blurred vision
- Change in mental status
- Restlessness
- Anxiety
- Decreased alertness, decreased ability to concentrate
- Fatigue
- Sleepiness, stuporous, lethargic
- Confusion
- Chest pain
- Mid-chest location most common
- Crushing or pressure sensation
- Cough
- Decreased urinary output
- Headache
- Nausea or vomiting
- Seizure
- Shortness of breath
- Weakness of the arms, legs, face, or other areas
Malignant hypertension is a medical emergency.
A physical exam commonly shows:
- Extremely high blood pressure
- Possible swelling in the lower legs and feet
- Abnormal heart sounds and fluid in the lungs
- Changes in mental status, sensation, muscle ability, and reflexes
An eye examination will reveal changes that indicate high blood pressure, including swelling of the optic nerve, retinal bleeding, narrowing of the blood vessels in the eye area, or other problems with the retina.
If not already present, kidney failure may develop as a complication of malignant hypertension. Other complications may also develop.
Tests to determine damage to the kidneys may include:
- BUN
- Creatinine
- Arterial blood gas analysis
- Urinalysis
A chest x-raymay show lung congestion and an enlarged heart.
This disease may also alter the results of the following tests:
- Aldosterone
- Cardiac enzymes (markers of heart damage)
- Electrocardiogram (EKG)
- Renin
- Urinary casts(sediment)
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 the hypertension. Your medication may need to be adjusted occasionally. Hypertension can be difficult to control.
Expectations (prognosis)Many body systems are in serious risk due to the extreme rise in blood pressure. Multiple organs of the body, including the brain, eyes, blood vessels, heart, and kidneys may be damaged. The blood vessels of the kidney are highly susceptible to damage caused by pressure, and kidney failure may develop, which may be permanent, requiring dialysis (kidney machine).
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- Brain damage due to:
- Heart damage, including:
- Heart attack
- Angina (chest pain due to narrowed blood vessels or weakened heart muscle)
- Heart rhythm disturbances
- Kidney failure
- Permanent blindness
- Pulmonary edema
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.
PreventionIf you have high blood pressure, carefully monitoring your blood pressure and taking your medicines properly help to reduce the risk. Eat a healthy diet, one that is low in salt and low in fat.
ReferencesBadr KF, Brenner BM. Vascular injury to the kidney. In: Fauci A , Kasper D, Longo DL, et al, eds. Harrison's Principals of Internal Medicine. 17th ed. New York, NY: McGraw Hill; 2008:chap 280.
What else can I help you with?
Is malignant hypertension coded as a cancerous blood disease?
Malignant hypertension is not cancerous.
What is the main diagnostic term for malignant hypertension with stage III kidney disease?
hypertension
What is the code for secondary malignant hypertension due to cushing's disease?
405.09,255.0
What does ICD-9 code 401.1 mean?
Essential hypertensionBenign essential hypertensionBenign essential hypertension401.1 Benign (for Hypertension)401.0 Malignant (for Hypertension)
Does Scleroderma cause death?
Malignant hypertension causes death in approximately 30% of cases
The term malignant when use in reference to hypertension is a?
d. condition related to high blood pressure
What is the medical term meaning sudden onset of severely elevated blood pressure?
malignant hypertension
Design a psychological model of treatment of a patient suffering from malignant hypertension?
Psychological treatment for a patient with malignant hypertension would typically involve stress management techniques, cognitive-behavioral therapy to address underlying psychological stressors contributing to hypertension, and lifestyle modifications like mindfulness practices and relaxation exercises. It's important to work collaboratively with medical professionals to ensure a holistic and coordinated approach to treatment. Regular monitoring and adjustment of the treatment plan based on the patient's progress and medical condition is crucial for long-term management of malignant hypertension.
What is visual malignant hypertension in young people?
Visual malignant hypertension in young people refers to a severe form of hypertension that leads to significant eye damage, often manifesting as retinal changes like hemorrhages, exudates, and swelling of the optic disc. This condition can result from underlying issues such as renal disease, endocrine disorders, or use of certain medications. Prompt diagnosis and treatment are crucial to prevent permanent vision loss and other serious complications. Young individuals experiencing symptoms like blurred vision or headaches should seek immediate medical attention.
Does the adrenal cortex cause high blood pressure?
Yes. You have higher than normal blood pressure in Cushing's syndrome. The adrenal medulla is directly responsible for malignant hypertension, as in Pheochromocytoma..
If your blood pressure is below normal why can't you discontinue blood pressure medications without contacting a doctor?
If you have been diagnosed with hypertension (consistently high blood pressure) and have been put on antihypertensive medication, discontinuing it without a doctor's supervision could cause the hypertension to recur, or even cause an episode of malignant hypertension, which can be life-threatening. If your blood pressure is consistently below normal, notify your doctor so he can adjust your medication if needed.
How long before malignant tendencies become malignant?
There is no specific amount of time for malignant tendencies to turn malignant. If they are going to become malignant, they will usually do so within months.
