What Is Malignant Hypertension?
Hypertension, or high blood pressure, is a common condition that
affects 1 in 3 Americans. High
blood pressure is diagnosed if one or both of the following occur:
- Your systolic blood pressure is consistently over
- You diastolic blood pressure is consistently
High blood pressure is generally manageable if you follow your
Although it’s not common, some people with high blood pressure
may have a rapid rise in blood pressure above 180/120 mm Hg. This is known
as malignant hypertension.
This condition is sometimes referred to as arteriolar nephrosclerosis.
Malignant hypertension requires immediate medical attention. If
you don’t get emergency treatment, you may develop serious health problems,
such as a heart attack, stroke, or kidney failure.
What Are the Symptoms of Malignant Hypertension?
High blood pressure is commonly referred to as the “silent
killer” because it doesn’t always have obvious signs or symptoms. Unlike moderate
high blood pressure, malignant hypertension has very noticeable symptoms that
- changes in vision including blurred vision
- chest pain
- a cough
- nausea or vomiting
- numbness or weakness in the arms, legs, or face
- shortness of breath
- a headache
- reduced urine output
Malignant hypertension can also result in a condition known as
The symptoms of this disorder include:
- severe headache
- blurry vision
What Causes Malignant Hypertension?
Malignant hypertension mostly occurs in people with a history of
high blood pressure. It’s also more common in African-Americans, males, and
people who smoke. It’s especially common in people whose blood pressure is
above 140/90 mm Hg. About 1
percent of people with high blood pressure develop malignant hypertension.
Some health issues increase your chances of having malignant
hypertension. These include:
- kidney disorders or kidney failure
- the use of drugs like cocaine, amphetamines, birth
control pills, or monoamine oxidase inhibitors (MAOIs), which are a class of
- pregnancy and preeclampsia, which occurs when a
woman develops high blood pressure and protein in the urine in the late 2nd to
3rd trimester of pregnancy
- autoimmune diseases, which are a result of the
body making antibodies against its own tissues
- spinal cord injuries causing parts of the
nervous system to become overactive
- renal stenosis, which is a narrowing of the
arteries of the kidneys
- a narrowing of the aorta, which is the main
blood vessel leaving the heart
- aortic dissection, which is bleeding along the
wall of the aorta
- not taking your medication for high blood
In some cases, these symptoms may not be due to malignant
hypertension. They may be related to other health conditions that are less
serious. However, malignant hypertension is so serious that you should seek
emergency medical help if you have any of these symptoms. Your doctor will be
able to provide you with more information about your condition.
How Is Malignant Hypertension Diagnosed?
Your doctor will ask you about your health history including any
treatments you’re on for high blood pressure. They’ll also measure your blood
pressure. This will help to determine whether or not emergency treatment is
Determining Organ Damage
Other tests may be used to see if your condition has resulted in
organ damage. For instance, blood tests measuring BUN and creatinine levels
may be ordered. BUN stands for blood urea nitrogen, which measures the amount
of waste product from the breakdown of protein in the body. Creatinine is a
chemical produced by the breakdown of muscles. Your kidneys clear it from your
blood. When the kidneys aren’t functioning normally, these tests will be
abnormal. Your doctor may also order the following:
- an echocardiogram
or ultrasound to look for heart damage
- a urine test to measure
proteins caused by kidney damage
- an electrocardiogram
(EKG) to measure the electrical functioning of the heart
- a renal ultrasound to look for additional kidney
- an eye exam to determine if damage to the eye
How Is Malignant Hypertension Treated?
Malignant hypertension is a medical emergency. You need to get
treatment for it immediately to lower your blood pressure and avoid dangerous
complications. Typically, treatment includes using high blood pressure
medications given intravenously, which means they go directly into your bloodstream
through a vein in your arm. This allows for immediate action. These medications
are called antihypertensive
Once your blood pressure has been stabilized, your doctor will
prescribe oral blood pressure medications. These medications will enable you to
control your blood pressure at home. If you’re diagnosed with malignant
hypertension, you’ll need to follow your doctor’s recommendations. This will
include having regular checkups to monitor your blood pressure.
How Can Malignant Hypertension Be Prevented?
Some cases of malignant hypertension can be prevented. If you
have high blood pressure, it’s important for you to check your blood pressure
regularly. It’s also important for you to take all prescribed medications
without missing any doses. Also, try to maintain a healthy lifestyle and follow
your doctor’s advice. Seek immediate treatment if you get any of the associated
symptoms. You’ll need urgent care to help reduce organ damage.
Tips to Lower Your Blood Pressure
The following are tips to
lower your blood pressure
- Adopt the Dietary Approaches to Stop
Hypertension (DASH) diet, which includes eating fruits, vegetables, low-fat
dairy products, foods high in potassium, whole grains, and avoiding or limiting
- Limit your salt intake to 1,500 milligrams per
day if you’re African-American, over 50 years old, or if you have diabetes,
hypertension, or chronic kidney disease. Keep in mind that processed foods can
be high in sodium.
- Exercise for a minimum of 30 minutes per day.
- Lose weight to get to a healthier weight for
your height and body size.
- Learn stress management techniques, such as deep
breathing or meditation.
- If you smoke, quit smoking.
- Try to limit alcoholic drinks to two per day if
you’re a man and one drink per day if you’re female or over 65 years old.
- Use a device at home to watch your blood