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Malignant high blood pressure (malignant hypertension) is very high blood pressure that comes on suddenly and is an emergency. If not treated, it can damage the brain, heart, eyes, or kidneys.
Symptoms include numbness, blurry vision, chest pain, severe headache, and confusion.
This problem is also called hypertensive crisis or hypertensive emergency.
Quick-acting medicines are used to lower blood pressure.
The cause may be unknown. Or the problem may be caused by medicine or another condition.
Call 911 anytime you think you may need emergency care. This may mean having symptoms that suggest that your blood pressure is causing a serious heart or blood vessel problem. Your blood pressure may be over 180/110.
For example, call 911 if:
Do not wait until your blood pressure comes down on its own. Get help right away.
Call your doctor now or seek immediate care if:
Watch closely for changes in your health, and be sure to contact your doctor if:
Malignant high blood pressure can cause:
It is better to prevent episodes of malignant high blood pressure than to treat an episode after you have already had one. One of the most common causes of malignant high blood pressure is not taking your blood pressure medicines properly. Sometimes this happens unintentionally. For example, your prescription may run out or you may forget to take a dose. But try to stay on your medicine schedule as best as you can. Another cause of malignant high blood pressure is illegal drug use, such as stimulants like cocaine.
To treat malignant high blood pressure, doctors and nurses will carefully monitor your blood pressure and give you medicine intravenously (through a needle inserted in one of your veins). The immediate goal is to lower your blood pressure enough so that your organs are no longer in immediate danger. But it must be lowered slowly so that your body has enough time to adjust to the change in blood pressure. If blood pressure is lowered too quickly, your body may have a hard time getting blood to your brain.
The other goal of treatment is to treat organ complications. For example, your doctor may give you a diuretic if you have fluid buildup in your lungs. Or your doctor may give a beta-blocker and nitrates if you have myocardial ischemia (not enough blood is reaching your heart). After your doctor has lowered your blood pressure to a safe level and treated your complications, he or she will try to identify the cause of the acute episode. Your doctor will then work with you to create a treatment regimen that can help prevent future attacks.
Other Works ConsultedAtkins GB, et al. (2011). Diagnosis and treatment of hypertension. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 2, pp. 1585–1605. New York: McGraw-Hill.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineMartin J. Gabica, MD - Family MedicineKathleen Romito, MD - Family MedicineAdam Husney, MD - Family MedicineSpecialist Medical ReviewerRobert A. Kloner, MD, PhD - Cardiology
Current as ofDecember 6, 2017
Current as of: December 6, 2017
Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine & Martin J. Gabica, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine & Robert A. Kloner, MD, PhD - Cardiology
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