When blood pressure starts causing injury to organs, especially the nervous system, the cardiovascular system, and/or the kidneys, it is called Malignant Hypertension. A condition known as Papilledema is one example of such injury. Papilledema is a condition in which the optic nerve leading to the eye becomes dangerously swollen to the point of endangering vision.



Rapid treatment from your health care provider is required as this condition is serious. Rapid treatment can prevent long-term problems. When left untreated, injury from Malignant Hypertension occurs quickly and can be severe, involving organ damage to blood vessels, the eyes, heart, spleen, kidneys, and brain. The blood vessels inside the kidneys are very sensitive to high blood pressure. This makes kidney failure a likely condition for anyone stricken with Malignant Hypertension.

Recognizing The Causes

Having high blood pressure is the distinct indicator, but other medical conditions leading to the development of Malignant Hypertension include:

* History of kidney disorders or failure

* Taking particular drugs or medications, including cocaine, amphetamines, monoamine oxidase inhibitors (MAOIs), and oral contraceptives

* History of collagen vascular diseases

* Pregnant women with Preeclampsia and Eclampsia

* Pheochromocytoma

* Spinal cord disorders

* Coarctation or dissection of the aorta

* Renal Artery Stenosis or narrowing of the arteries to the kidneys

* Missing doses of prescribed antihypertensive medications,especially beta-blockers or clonidine (Catapress), which can cause a boomerange effect. Medication noncompliance is the most common reason for hypertensive emergencies.

Recognizing Risk Factors

Something that increases your chance of getting a disease or condition is a risk factor. You are more likely to develop Malignant Hypertension if you already have high blood pressure of 140/90 or higher. Your risk may increase further if you are:

* Male

* African American

* A smoker

Recognizing Specific Symptoms

Malignant Hypertension produces noticeable symptoms, including:

* Chest pain

* Difficulty with breathing

* Headache

* Visual problems

* Nausea and vomiting

* Numbness or weakness of the legs, arms, face

Specifically, Malignant Hypertension may lead to a condition called Hypertensive Encephalopathy. Symptoms of this condition include: headache, vomiting, blurry vision with papilledema, mental changes like anxiety, confusion, fatigue, and seizure.

If you experience any of the listed symptoms do not assume it is due to Malignant Hypertension. These symptoms may be caused by other health conditions, including a heart attack or other less serious disorders. See your health care provider as soon as possible if you experience any of these symptoms.

Then Comes the Diagnosis

Your health care provider will perform a physical exam and ask about your symptoms and medical history. Your blood pressure readings will probably be very high. Readings will be taken in both arms while lying down and again while standing. A careful exam of your heart with a stethoscope and a detailed neurological exam will be performed. An eye exam may show signs of high blood pressure, including swelling of the optic nerve or bleeding inside the eye.

Tests may include the following:

* Blood tests for BUN and creatinine levels to check for kidney damage

* Chest x-ray

* Echocardiogram or ultrasound of the heart to look for heart damage

* Urine tests for high levels of protein, small amounts of blood or abnormally high levels of certain hormones

* EKG to look at the heart's electrical functioning

* Renal duplex or ultrasound test of the kidney's arteries to look for blockage

The Treatment Options

Malignant Hypertension is a medical emergency. Therefore, treatment needs to be received quickly. Treatment options include the following:

* Intravenous high blood pressure medications - the specific medication will be chosen based on your specific situation, including whether you are suffering from damage to your kidneys or other organs. Useful medications may include:

* Sodium nitroprusside or nitroglycerin

* Beta-blockers

* Hydralazine

* Labetalol

* Vasotec (enalapril) and ACE-inhibitor

* Oral high blood pressure medications once blood pressure has been lowered to safe levels

* Dialysis

Practice Prevention.

Take the following steps to reduce your chance of developing Malignant Hypertension:

* Frequently check your blood pressure levels.

* Report any sustained high blood pressure to your health care professional.

* Take all prescribed high blood pressure medicines on schedule and avoid missing doses.