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Malignant Hypertension

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Introduction

Various forms of hypertension, also referred to as high blood pressure, or simply HBP, are today experiences across all nations around the globe. Some hypertensions are mild while other are fatal and can cause death as a result of stroke, body organs failures or congestion of blood in the body vessels.

Definition of Malignant Hypertension

This is a type of high blood pressure that attacks an individual suddenly and acutely. In malignant hypertension, the lower blood pressure (diastolic) reading is usually as high as above 150 mmHg and the systolic level goes beyond 200 mmHg. Malignant hypertension is also called arteriolar nephrosclerosis or accelerated hypertension. It is a syndrome characterized by severe hypertension due to sudden increase in the baseline blood pressure (BP).

It usually affects the central nervous system (CNS), the renal system and the cardiovascular system, and results into permanent damage to affected body organs. Occurrence of malignant hypertension also results into destruction of the red blood cells as they flow vessels blocked by fibrin deposition (Gudbrandsson, 1981). This sudden increase in blood pressure often becomes a threat to the life of the patient.

Causes of Malignant Hypertension

Malignant hypertension is common in persons with history of high blood pressure, especially children and young adults. It may also occur in people with collagen vascular disorders, kidney problems and pregnant women suffering from toxemia or complications of pregnancy. The risk of attack increases in persons who have once suffered from kidney failure and renal hypertension as a result of renal artery stenosis. It is believed that malignant hypertension may be caused by monoamine oxidase Inhibitors (MAOIs) and some oral contraceptives used in birth control (Hilme, 1993).

Symptoms

Different patients show different symptoms for malignant hypertension. However, the major symptoms include blurred vision, body fatigue, insomnia, restlessness, unconsciousness and various changes in mental status such as angst, confusion and lack of proper concentration. Some patients may also suffer from chest pains, mild coughs, severe headaches and nausea. In cases where the kidney is affected, reduction in urination is experienced. Similarly, there may be attack of certain body organs such as the kidney. Some people have been reported to have difficulties in breathing and general body weakness, especially at the legs and arms.

Diagnosis and Examination

Malignant hypertension is an emergency attack. Diagnosis of malignant hypertension thus includes physical examinations such as determination of blood pressure, identification of body swellings especially in the lower feet, assessing the presence of fluid in the lungs and any abnormal heartbeat rates. According to Lip and Nadar, malignant hypertension usually affects the functionality of the brain and thus the physician must verify any symptom of change in thinking, reflexes, and/or sensation (Lip & Nadar, 2009). Through medical observations and examination of the patient’s eyes, it is possible to identify presence of retinal bleeding, optic nerve swelling as well as possibility of narrowed blood vessels. These indicate presence of high blood pressure. When a patient is attacked by malignant hypertension, he or she is likely to develop kidney failure. The physician can thus perform Urinalysis or Blood Urine Nitrogen (BUN) tests to identify possible damages to the kidneys. Additionally, an X-Ray of the chest may be carried out to examine if the lungs and the heart are affected.

Treatment

Due to its severity, malignant hypertension requires urgent assessment and treatment. A patient may be required to be hospitalized for a period of more than one month until the high blood pressure is put under control. During treatment and medication, drugs that regulate high blood pressure are usually administered through the veins, for example, Nitroprusside Dilator and Fenoldopam which increase blood in the renal vessels.

Kaplan and Victor suggest that in case fluids are found in the lungs, then diuretics are performed. Diuretics help the body in removing excess fluids form the lungs (Kaplan & Victor, 2009). Moreover, it is recommended that patients should use drugs that protect the heart from further destruction if damages to the heart were diagnosed. Drugs that help to stop internal bleeding of the retinas are also given to the patient. The choice of drugs used in treatment of malignant hypertension varies depending on the health status of the patients, severity of attack, lack of difficulty in administration and possibility of development of side effects.

Prognosis of Malignant Hypertension

Malignant hypertension exposes various body systems at increased risks due to increased blood pressure. Certain vital organs of the body such as the kidneys, heart and brain may be destroyed. Malignant hypertension also puts the eyes and blood vessels at risks.

In extreme cases, permanent kidney failure may occur, a condition which may force the patient to undergo dialysis. Hilme warns that malignant hypertension requires early diagnosis and treatment to reduce such life-threatening complications (Hilme, 1993).

Possible Complications of Malignant Hypertension

The major complications observed in many patients of malignant hypertension are damages to the brain and the heart, kidney failure and pulmonary edema, that is, presence of fluids in the lungs. The patient may experience angina. Gudbrandsson defines angina as chest pain that result from narrowed blood vessel. Retinal destruction may also lead to permanent blindness (Gudbrandsson, 1981).

Conclusion

It is important to seek medical attention whenever a patient experiences sudden increase in blood pressure or shows symptoms of malignant hypertension. Appropriate action should be taken to save the patient from this deadly disease. It is advisable for people to practice healthy lifestyles such doing exercises regularly, taking healthy diets with low levels of salt, fat and cholesterols, and taking medications that monitor one’s blood pressure.

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