Malignant hypertension means an abnormal increase in mean arterial pressure, so consistent as to cause serious damage to the eye, and beyond. The "adjective" malignant "does not therefore refer to a" hypothetical cancerous origin, but to the serious damage that this syndrome can cause. If left untreated, malignant hypertension is in fact aggravated by a mortality of over 90% over the course of a year. The prognosis however depends on the average pressure levels reached and on the speed with which this syndrome was established and was treated; when medical treatment comes early, the prognosis is good.
Malignant hypertension should not be confused with hypertensive crisis, which is instead acute. Rather, malignant hypertension can be considered a particularly unfavorable evolution of hypertension; as such it can affect people suffering from high blood pressure at any time and at any age. To prevent its onset, it is important to periodically check your blood pressure and - in case of hypertension - take the medicines in the manner prescribed by the doctor, respecting at the same time any dietary and behavioral measures aimed at reducing weight and sodium intake.
Among the signs, symptoms and diagnostic findings typical of malignant hypertension, we remember:
- diastolic blood pressure generally above 130-140 mmHg;
- systolic blood pressure generally above 200 mmHg;
- papillary edema, hemorrhage and retinal exudation;
- headache, vomiting, anxiety, cerebral haemorrhage, nausea, blurred vision, up to convulsions, stupor, coma;
- hematuria, proteinuria with a tendency to evolve into renal insufficiency, poor urine output;
- electrocardiographic signs of functional overload of the left ventricle, heart failure, chest pain, cough, shortness of breath.
Treatment of malignant hypertension requires hospitalization to treat and prevent complications, to administer adequate intravenous drugs and to monitor the function of the various organs. Once the blood pressure has stabilized, the patient is discharged from the hospital; the home therapy continues from a preventive point of view through the administration of drugs against hypertension, such as Beta-Blockers and ACE-inhibitors. Additional medications or special treatments may be needed if malignant hypertension has caused organ damage.
