Malignant hypertension

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Malignant hypertension is a rare disease characterized by a significant rise in blood pressure accompanied by cardiac, renal or neurological failure and an impact on the retina. The blood pressure is above 180 mm Hg for systolic pressure (at the beginning of the contraction of the heart) or above 110 mm Hg for diastolic (at the end of the contraction). The course of the disease can be fatal in the absence of treatment. Malignant hypertension may be responsible for several complications such as stroke, a rupture of the walls of the aorta (aortic dissection) or acute renal failure.


Symptoms of malignant hypertension are:
  • Systolic blood pressure> 180 mm Hg or diastolic pressure> 110 mm Hg;
  • retinopathy in fundus, in the case of emergency;
  • a sign of retention:

o heart (myocardial infarction or pulmonary edema);
o kidney (acute renal failure);
o neurological (stroke, confusion, headache, seizure).


The diagnosis of malignant hypertension is made after blood pressure is taken and signs of visceral pain can be identified. In the case of emergency, a blood test, electrocardiogram and other examinations guided by the clinical signs are performed: brain scan, echocardiography...


Treatment depends on the progress of the disease: if there is good tolerance and an absence of signs of severity, monitoring at rest and repeated measurements of blood pressure are needed. In an emergency, infusion will be performed and a antihypertensive treatment will be given through the veins.

Recommended measures to control blood pressure are a low-salt diet, avoiding being overweight, and fighting against cardiovascular risk factors: smoking cessation and alcohol, controlling diabetes, reducing cholesterol.