Malignant hypertension (arteriolar nephrosclerosis)

Alternative names:

accelerated hypertension; arteriolar nephrosclerosis; hypertension - malignant; nephrosclerosis - arteriolar

Definition:

Severely high blood pressure together with hemorrhages and dead tissue (infarcts) or swelling of the optic nerve (papilledema).

Causes, incidence, and risk factors:

Malignant hypertension is a medical emergency condition where there is a sudden and severe rise in the blood pressure. The cause is unknown, but there is often a prior history of hypertension, especially hypertension resulting from kidney disorders (secondary hypertension).

The disorder affects about 3 out of 10,000 people, both children and adults. It is more common in younger adults, especially African American men. It also occurs in women with toxemia of pregnancy, and people with renal or collagen vascular disorders. A history of acute renal failure or renal hypertension caused by renal artery stenosis indicates a high risk for malignant hypertension.

There is a sudden, rapid increase in blood pressure, usually for no observable cause. The disorder can cause severe, permanent, life-threatening consequences from pressure damage to multiple organs of the body, including the brain, eyes, blood vessels, heart, and kidneys. The blood vessels of the kidney are highly susceptible to damage caused by pressure, and acute renal failure may develop; this renal failure may be permanent.