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Malignant hypertension

Hypertensive kidney
Hypertensive kidney
Alternative Names

Accelerated hypertension; Arteriolar nephrosclerosis; Nephrosclerosis - arteriolar; Hypertension - malignant; High blood pressure - malignant


Treatment

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.


Support Groups


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:
    • Coma
    • Hypertensive encephalopathy
    • Intracerebral hemorrhage (bleeding in the brain)
    • Seizures
    • Spasm or constriction of the arteries of the brain
    • Stroke
    • Swelling
  • 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

Calling your health care provider

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.



Review Date: 04/20/2009
Reviewed By: Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).
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