Accelerated hypertension (high blood pressure), more commonly known as malignant hypertension, is sudden, extremely high blood pressure. It is considered to be a medical emergency. Emergency medical responders, nurses and physicians are trained to rapidly assess, diagnose and treat the condition. They are also trained to look for complications and to counsel a person regarding risk factors for the development of malignant hypertension.
Risk Factors
According to the University of Maryland Medical Center, malignant hypertension affects 1 percent of people with high blood pressure. It is more common in African-American men and younger adults, but can happen to anybody. Pregnant women are also at higher risk, as are people with kidney failure or renal artery stenosis, which is a condition in which an artery to the kidney provides less blood flow to the kidney. Even though the blood pressure in the rest of the body is normal, the affected kidney senses low blood pressure, and signals the entire body to raise blood pressure.
Symptoms
Symptoms occur from the suddenly high blood pressure. According to the National Institutes of Health (NIH), the victim may experience one or more of the following in combination: numbness, weakness, blurry vision, headache, chest pains, mental status changes, cough, nausea, vomiting, decreased urine output, seizures and shortness of breath.
Diagnosis
First, a physical exam is performed. Typically, when a person appears before a health care provider, vital signs are quickly taken. These include pain level, breathing rate, heart rate, temperature and blood pressure. In malignant hypertension, the diastolic pressure, which is on average 80 mmHg, may be up to or over 130 mmHg, according to the National Institutes of Health. Other tests will determine the extent to which the high blood pressure is affecting the body. These may include a chest X-ray to look for an enlarged heart or fluid in the lungs, blood tests to look at kidney function, a CT scan of the head if there are mental status changes, and an eye exam.
Treatment
The treatment involves slowly lowering the blood pressure. Ideal drugs to treat malignant hypertension are those that act quickly and have a short duration in case the blood pressure gets too low. Two such drugs are nitroprusside, and labetalol which is given intravenously. The drug dilates the arteries and veins to lower blood pressure. Labetalol slows heart rate and dilates the arteries. Other drugs are available as well.
Complications
According to the NIH, if not treated promptly, malignant hypertension may cause permanent damage or be life threatening. It can cause brain damage in a number of different ways, including through brain swelling and strokes. It can damage the heart by causing heart attacks and can cause fluid build-up in the lungs, blindness and kidney failure.
Prognosis
If treated promptly, malignant hypertension may not result in the complications listed above. However, people who develop malignant hypertension usually have a history of high blood pressure, are at risk for recurrences of the condition and are at risk for disease to many organs from high blood pressure, including the kidneys, heart and brain. Therefore, regular exams and management by a health care professional are warranted.
