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Causes for Swollen Ankles With High Blood Pressure

author image Dr. Tina M. St. John
Tina M. St. John runs a health communications and consulting firm. She is also an author and editor, and was formerly a senior medical officer with the U.S. Centers for Disease Control and Prevention. St. John holds an M.D. from Emory University School of Medicine.
Causes for Swollen Ankles With High Blood Pressure
High blood pressure with edema usually indicates a serious underlying condition.

Fluid balance in the human body requires the coordinated function of multiple body systems. The cardiovascular and urinary systems prove particularly important in regulating the distribution of water between the bloodstream and the body tissues. Abnormalities of one of both of these systems can potentially cause a fluid imbalance, leading to high blood pressure, swollen ankles and other accompanying symptoms and signs.

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Hypertensive Heart Failure

Chronic high blood pressure may lead to heart damage and a condition known as hypertensive heart disease. The lower left chamber of the heart thickens in response to pumping against persistently elevated pressure in the arteries. The thickening causes heart stiffness and impairs function. These abnormalities lead to poor filling of the heart chamber and less blood delivery to the circulation with each heartbeat, note Drs. Joseph Diamond and Robert Phillips in a March 2005 review article published in the journal "Hypertension Research." Hypertensive heart disease often progresses to heart failure.

Patients with hypertensive heart failure retain excess fluid in the body, which commonly leaks into the tissues. Swelling of the feet, ankles and lower legs proves a classic symptom of heart failure. Other common symptoms include shortness of breath, cough, fatigue and fluid accumulation in the abdomen, reports the National Heart Lung and Blood Institute.

Nephrotic Syndrome

Nephrotic syndrome is a kidney condition characterized by damage to the blood filtering units, which leads to loss of large quantities of protein in the urine. Many medical conditions can cause nephrotic syndrome, including diabetes mellitus, multiple myeloma, systemic lupus erythematosus, lymphoma and leukemia, reports "The Merck Manual for Healthcare Professionals." Certain kidney-toxic medications can also lead to nephrotic syndrome.

Common symptoms and signs of nephrotic syndrome include high blood pressure, swelling of the feet and ankles, facial puffiness, accumulation of fluid in the abdomen and rapid weight gain, notes the National Library of Medicine encyclopedia MedlinePlus.

Malignant Nephrosclerosis

Profoundly elevated blood pressure damages the small blood vessels of the kidneys, leading to a condition known as malignant nephrosclerosis. The disruption in blood flow causes widespread tissue damage, typically leading to acute kidney failure within hours to days, reports the medical information website

Patients with acute kidney failure retain fluid due to impaired filtration of the blood. An array of symptoms develops, including nosebleeds and bruising; nausea and vomiting; numbness of the hands and feet; fatigue; mental changes; and swelling of the feet and ankles, reports MedlinePlus. Patients with acute kidney failure caused by malignant nephrosclerosis exhibit markedly elevated blood pressure.

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