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Malignant Hypertension Causes Symptoms And Treatment
Malignant Hypertension and accelerated high blood pressure are two emergency conditions which should be treated promptly. Both conditions have same outcome and therapy. However Malignant hypertension is a complication of high blood pressure characterized by very elevated high blood pressure, and organ damage in the eyes, brain, lung and/or kidneys. It differs from other complications of hypertension in that it is accompanied by papilledema. (Edema of optic disc of eye) Systolic and diastolic blood pressures are usually greater than 240 and 120, respectively. While Accelerated high blood pressure is condition with high blood pressure, target organ damage, on fundoscopy we have flame shaped hemorrhages, or soft exudates, but without papilledema.
There are two things. Hypertensive Urgency and Hypertensive emergency. In hypertensive urgency we don’t see any target organ damage while in emergency we see target organ damage along with high blood pressure greater than systolic >220. Now depending upon target organ damage you will decide whether you have hypertensive emergency or urgency. It is essential to bring down high blood pressure in hypertensive emergency immediately, while in urgency, bring down blood pressure very rapidly is not required.
Pathogenesis of malignant hypertension is fibrinoid necrosis of arterioles and small arteries. Red blood cells are damaged as they flow through vessels obstructed by fibrin deposition, resulting in microangiopathic hemolytic anemia. Another pathologic process is the dilatation of cerebral arteries resulting in increased blood flow to brain which leads to clinical manifestations of hypertensive encephalopathy. Common age is above 40 years and it is more frequent in man rather than women. Black people are at higher risk of developing hypertensive emergencies than the general population.
Target organs are mainly Kidney, CNS and Heart. So symptoms of Malignant hypertension are oligurea, Headache, vomiting, nausea, chest pain, breathlessness, paralysis, blurred vision. Most commonly heart and CNS are involved in malignant hypertension. The pathogenesis is not fully understood. Up to 1% of patients with essential hypertension develop malignant hypertension, and the reason some patients develop malignant hypertension while others do not is unknown. Other causes include any form of secondary hypertension; use of cocaine, MAOIs, or oral contraceptives; , beta-blockers, or alpha-stimulants. Renal artery stenosis, withdrawal of alcohol, pheochromocytoma {most pheochromocytomas can be localized using CT scan of the adrenals}, aortic coarctation, complications of pregnancy and hyperaldosteronism are secondary causes of hypertension. Main Investigations to access target organ damage are complete renal profile, BSR, Chest Xray, ECG, Echocardiography, CBC, Thyroid function tests.
Management:
Patient is admitted in Intensive Care Unit. An intravenous line is taken for fluids and medications. The initial goal of therapy is to reduce the mean arterial pressure by approximately 25% over the first 24-48 hours. However Hypertensive urgencies do not mandate admission to a hospital. The goal of therapy is to reduce blood pressure within 24 hours, which can be achieved as an outpatient department. Initially, patients treated for malignant hypertension are instructed to fast untill stable. Once stable, all patients with malignant hypertension should take low salt diet, and should focus on weight lowering diet. Activity is limited to bed rest until the patient is stable. Patients should be able to resume normal activity as outpatients once their blood pressure has been controlled.
Hospitalization is essential until the severe high blood pressure is under control. Medications delivered through an IV line, such as nitroglycerin, nitroprusside, or others, may reduce your blood pressure. An alternative for patients with renal insufficiency is IV fenoldopam. Beta-blockade can be accomplished intravenously with esmolol or metoprolol. Labetalol is another common alternative, providing easy transition from IV to oral (PO) dosing. Also available parenterally are enalapril, diltiazem, verapamil, Hydralazine is reserved for use in pregnant patients as it also increases uterine profusion, while phentolamine is the drug of choice for a pheochromocytoma crisis. After the severe high blood pressure is brought under control, regular anti-hypertensive medications taken by mouth can control your blood pressure. The medication may need to be adjusted occasionally.
Remember, It is very necessary to control malignant hypertension, otherwise it can lead to life threatening conditions like Heart Failure, Infarction, Kidney failure and even blindness.
If you want to know more about Malignant Hypertension, visit our site highbloodpressuremed.com
News Jobs & Trends .Marketing Communications
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Life Sciences Expert LaVoie Joins IPREXThe Holmes ReportBased in Boston, LaVoie Group offers strategic communication, including strategy consulting, public relations, investor relations as well as corporate and marketing communication. The agency has a specific focus on understanding the life science ... |
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New Media SpecialistEmirates 24/7? Assisting the Management in coordinating various integrated ?communication and marketing activities including online holistic campaigns. ? Coordinating in production of a wide range of marketing communications tools. |
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Volkswagen Appoints Kevin Mayer Vice President, MarketingExec Digital (press release)Prior to his General Motors appointment, Mayer held marketing and advertising roles with Subaru, Colby & Partners, Mitsubishi Motors and Hyundai of America. He earned an undergraduate degree in Communications from Purdue University and an MBA in ...and more » |
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New Job, First Expo, Chamber's Justin Kropff Gives His AssessmentPatch.comAs the newly named director of marketing and communications for the Greater Brandon Chamber of Commerce, Justin Kropff said he moved to Tampa to join his wife, Allison Kropff, who works at WTSP Channel 10 News. By Linda Chion Kenney Justin Kropff, ... |
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Ibadan set to host Glo Laffta FestThe Nation NewspaperAccording to a statement from the Marketing Communications Department of Globacom, top-rated Nigerian artistes led by comedian Gbenga Adeyinka would be on hand to entertain the people free of charge. Other artistes scheduled to perform at the event ... |
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Avaya and IDG Debut the CIO Collaboration NetworkEON: Enhanced Online News (press release)(EON: Enhanced Online News)--To provide an online destination for content and discussion related to business collaboration and communications, The CIO Collaboration Network is a destination for IT executives who can access content, share views, ...and more » |
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Visual Marketing Systems Loves to Print GreenPatch.comThe Sustainable Green Printing Partnership is an independent non-profit organization that provides certification labeling for the graphics communications industry. The goal of the SGP is to provide a framework for manufacturers in the graphics and ...and more » |
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Communications DirectorPoynter.orgThe Director of Communications will be the program's chief communications strategist and manager, using marketing and communications tools to achieve our ambitious vision. The Director will oversee media strategy and outreach, online engagement, ... |
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SPS 2012: Marketing 'green' to the mainstreamPackaging WorldWith a majority of US consumers identifying with green values, brand owners must learn how to effectively communicate their green message in a relevant way. By Anne Marie Mohan, Editor, Greener Package Not long ago, green products and services appealed ... |
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Journal Broadcast seeks Green Bay TV duopolyMilwaukee Business JournalThe Milwaukee-based unit of Journal Communications Inc. (NYSE: JRN) is seeking approval from the Federal Communications Commission to own both stations, creating a duopoly in the Green Bay television market. Journal Broadcast Group has operated WACY-TV ... |
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Peter Sessa, Pam Green Exit Dial GlobalAll Access Music GroupLongtime WESTWOOD ONE/DIAL GLOBAL VP/Marketing and Communications PETER SESSA has left DIAL GLOBAL. SESSA joined WW1 in 2000 after graduating from SUNY-CORTLAND in 1999 and remained on board after last year's merger into DIAL GLOBAL.and more » |
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