About this topic

Malignant hypertension is an illness where the pressure in your blood vessels is very high. The blood pressure is so high that it starts to harm organs of the body. This illness most often happens in people with kidney and blood vessel problems, and during pregnancy.
Doctors find this illness by taking your blood pressure and doing tests like blood tests, x-rays, and ECG. People with this illness need to be treated in a hospital. Doctors will work to lower the blood pressure. They will also want to find and treat the cause of the high blood pressure.

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What are the causes?

• Pressure in blood vessels gets too high
• Tumors
• Certain drugs
• Using illegal drugs

What can make this more likely to happen?

You are more likely to have this problem if you have problems with high blood pressure, your kidneys, or blood vessels. Younger adults and African-American males are at higher risk. Being pregnant may also make this more likely to happen.

What are the main signs?

• Eye problems like blurring, bleeding, or swelling of nerves
• Change in mental status like confusion, not alert, anxious, sleepy
• Chest pain or heart attack
• Trouble breathing, coughing
• Less urine output and kidney failure
• Upset stomach and throwing up
• Numbness or weakness of arms, legs, face, or other body parts
• Swelling or bleeding in the brain
• Stroke
• Seizure

How does the doctor diagnose this health problem?

Your doctor will take your history and do an exam. Your doctor will check your blood pressure and look for swelling in your legs or feet.Your doctor will listen to your heart and lungs. The doctor may order:

• Lab tests
• Eye exam
• Chest x-ray
• CT scan
• Electrocardiogram (ECG)
• Ultrasound

How does the doctor treat this health problem?

You will be treated in the hospital until your condition is under control. You will get drugs through an IV to lower your blood pressure. Your doctor will base your care on your vital signs. Some people may need kidney dialysis.

Are there other health problems to treat?

Doctors will work to treat the cause of the high blood pressure

What drugs may be needed?

The doctor may order drugs to:

• Help with pain
• Help with breathing

What problems could happen?

• Mental changes
• Stroke or heart attack
• Brain damage
• Kidney damage
• Eye problems or blindness
• Heart damage
• Fluid in the lungs

What can be done to prevent this health problem?

• Have your blood pressure checked often. This is very important if high blood pressure runs in your family.
• Take your blood pressure drugs as ordered. Avoid missing any doses.
• Eat a healthy diet. Avoid salty, fatty, and overly-sweet foods.

When do I need to call the doctor?

Activate the emergency medical system right away if you have signs of a heart attack or stroke. Call 911 in the United States or Canada.The sooner treatment begins, the better your chances for recovery. Call for emergency help right away if you have:

• Signs of heart attack:
  • Chest pain
  • Trouble breathing
  • Fast heartbeat
  • Feeling dizzy
• Signs of stroke:
  • Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause
• Call your doctor if you have:
  • Changes in behavior
  • Problems seeing
  • Coughing up blood
  • Bloody stool or vomit

Where can I learn more?

American Heart Association
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/HypertensiveCrisis_UCM_301782_Article.jsp

Reference: Malignant hypertension,Lexicomp,Wolters Kluwer Health, Inc