Malignant hypertension is the most severe and dangerous form of arterial hypertension. Its characteristic feature is that it quickly leads to the failure of many organs (including the heart and brain), which is a life-threatening condition. Untreated people can die within days of developing symptoms of malignant hypertension. What are the causes and symptoms of malignant hypertension? What is its treatment?

Malignant hypertension , also known as accelerated hypertension, ormalignant phase of hypertension , is a very rare, but most severe form ofof hypertension arterial . Malignant hypertension is characterized by such pressure values ​​that lead to damage and further necrosis of the middle wall of small and smallest arteries, i.e. those that supply blood to organs, e.g. brain, heart, kidney and liver. As a consequence, damage and failure of these organs occurs, which is a life-threatening condition.

It should be noted that in malignant hypertension, not only a very high value of arterial pressure, but also the rate of its increase is important. It is the sudden and excessive increase in blood pressure that exceeds a certain critical level that causes the characteristic changes in the vascular system and consequently to multi-organ failure.

Malignant hypertension is diagnosed less and less frequently, which results from the greater detection of arterial hypertension and the spread of antihypertensive treatment (lowering blood pressure to normal values). The prevalence of malignant hypertension among all patients with arterial hypertension is currently estimated at less than 1%. In this very narrow group, they are most often diagnosed in men around 44 years of age and women around 36 years of age.

Malignant hypertension - causes and risk factors

Malignant hypertensioncan develop in the course of untreated or poorly treatedessential hypertension(causes of which remain unknown) orsecondary arterial hypertension(caused by a specific disease), regardless of its severity. In the latter case, malignant hypertension is most often caused bykidney diseases in the course of which pathology of the kidney vessels or renal parenchyma occurs.

There is also a link between malignant hypertension and smoking and the use of oral contraceptives.

Malignant hypertension - symptoms

  • Clearly elevated diastolic blood pressure (it can reach a value of 140 or even 150 mmHg);
  • Progressive renal failure;
  • Symptoms of the central nervous system of varying severity: from weakness, through visual disturbances, severe headaches, to severe hypertensive encephalopathy.

Symptoms of other organs may also be predominant, e.g. the gastrointestinal tract (symptoms of acute pancreatitis or intestinal wall ischemia), heart attack.

Malignant hypertension - complications

  • Hypertensive retinopathy (damage to the retina of the eye);
  • Kidney damage;
  • Heart failure;
  • Pulmonary edema.

There is also a high risk of having a stroke.

Important

Malignant hypertension can quickly lead to death!

The development of malignant hypertension increases the risk of developing hypertensive encephalopathy. A sudden increase in blood pressure, to values ​​exceeding the adaptive capacity, leads to an increase in blood flow within the brain, and further to an increase in the permeability of arterial walls, the penetration of plasma components into the brain and its swelling, and consequently to death.

Malignant hypertension - diagnosis

The disease can be diagnosed on the basis of the above-mentioned symptoms. However, the final diagnosis is based on a fundus examination, which reveals the third or fourth stage of hypertensive retinopathy - retinal haemorrhages, effusions, and optic disc edema.

Malignant hypertension - treatment

The goal of treatment is to lower blood pressure to safe levels with the use of antihypertensive agents. Drugs are selected in the same way as for the treatment of essential hypertension. The doctor gives one drug, and in case of its ineffectiveness, the dose is increased or additional blood pressure lowering agents are added.

Malignant hypertension - important diet and physical activity

A very important element in the treatment of malignant hypertension is a low-calorie diet (1500 kcal / day) with the limitation of animal fats and simple carbohydrates, and rich in vegetables and fruits. In addition, the patient should limit the consumption of table s alt ( <6 g/dobę). Ważne jest także zwiększenie poziomu aktywności fizycznej, np. regularne spacery czy jazda na rowerze.

Category:

Cardiology