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Malignant Hypertension

Malignant hypertension is extremely high blood pressure that develops rapidly and causes some type of organ damage. "Normal" blood pressure is below 140/90. A person with malignant hypertension has a blood pressure that's typically above 180/120. Malignant hypertension should be treated as a medical emergency.

What Causes Malignant Hypertension?

In many people, high blood pressure is the main cause of malignant hypertension. Missing doses of blood pressure medications can also cause it. In addition, there are certain medical conditions that can cause it. They include:

  • Collagen vascular disease, such as scleroderma
  • Kidney disease
  • Spinal cord injuries
  • Tumor of the adrenal gland
  • Use of certain medications, including birth control pills and MAOIs
  • Use of illegal drugs, such as cocaine

 

Who's at Risk for Malignant Hypertension?

Malignant hypertension is rare. About 1% of people who have a history of high blood pressure develop this life-threatening condition.  

You are at greater risk of developing it if you are a man, African-American, or someone of lower economic status. Poor access to health care increases the risk.

 

What Are the Symptoms of Malignant Hypertension?

The main symptoms of malignant hypertension are a rapidly increasing blood pressure of 180/120 or higher and signs of organ damage. Usually, the damage happens to the kidneys or the eyes.

Other symptoms depend on how the rise in blood pressure affects your organs. A common symptom is bleeding and swelling in the tiny blood vessels in the retina. The retina is the layer of nerves that line the back of the eye. It senses light and sends signals to the brain through the optic nerve, which can also be affected by malignant hypertension. When the eye is involved, malignant hypertension can cause changes in vision.

Other symptoms of malignant hypertension include: 

  • Blurred vision
  • Chest pain (angina)
  • Difficulty breathing
  • Dizziness
  • Numbness in the arms, legs, and face
  • Severe headache
  • Shortness of breath

In rare cases, malignant hypertension can cause brain swelling, which leads to a dangerous condition called hypertensive encephalopathy. Symptoms include:  

  • Blindness
  • Changes in mental status
  • Coma
  • Confusion
  • Drowsiness
  • Headache that continues to get worse
  • Nausea and vomiting
  • Seizures

High blood pressure, in general, makes it difficult for kidneys to filter wastes and toxins from the blood. It is a leading cause of kidney failure. Malignant hypertension can cause your kidneys to suddenly stop working properly. 

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