(Hypertensive Emergency; Hypertensive Crisis; Hypertensive Urgency)
by Alice A. McCarthy, MBA
Malignant hypertension is blood pressure that is so high that it is damaging to the body. The brain, heart, blood vessels, eyes, and kidneys are most at risk.
This is a serious condition that will need immediate care. Rapid care can stop long-term problems. If it is not treated, malignant hypertension can quickly cause severe damage. It can lead to problems such as kidney failure or vision loss.
Poor management of high blood pressure may cause malignant hypertension. Other medical conditions that can lead to malignant hypertension include:
Risk Factors TOP
Malignant hypertension is more common in:
Malignant hypertension can cause:
Malignant hypertension can lead to hypertensive encephalopathy which can also cause:
Your doctor will ask about your symptoms and past health. A physical exam will be done. Blood pressure will be taken in both arms. It will be taken while you are lying down and while standing up. If the readings remain high the doctor will do the following:
To look for any damage that may have occurred your doctor may also order:
Treatment needs to be started quickly. Options will depend on what has been affected. Medication options include:
Tests will be done to look for any damage that may have happened. A treatment plan will be made to keep blood pressure in healthy levels.
If you have high blood pressure, you can decrease your chance of malignant hypertension with the following step:
American Heart Association
National Heart, Lung, and Blood Institute
The Society of Obstetricians and Gynaecologists of Canada
Varounis C, Katsi V, Nihoyannopoulos P, Lekakis J, Tousoulis D. Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature. Front Cardiovasc Med. 2016;3:51.
Hypertensive crisis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114059/Hypertensive-crisis . Updated March 5, 2018. Accessed October 2, 2018.
Arbe G, Pastor I, Franco J. Diagnostic and therapeutic approach to the hypertensive crisis. Med Clin (Barc). 2018 Apr 23;150(8):317-22.
Suneja M, Sanders ML. Hypertensive Emergency. Med Clin North Am. 2017 May;101(3):465-78.
Last reviewed September 2018 by EBSCO Medical Review Board James P. Cornell, MD
Last Updated: 10/2/2018
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