Malignant hypertension (arteriolar nephrosclerosis)

Alternative names:

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

Treatment:

Hospitalization is essential until the severe high blood pressure is under control.

Intravenous medications such as nitroprusside, nitroglycerin, or others may reduce blood pressure.

After the acute hypertension is brought under control, oral (by mouth) anti-hypertensive medications can maintain control of the blood pressure. The medication may need to be adjusted occasionally. Hypertension can be difficult to control.

Expectations (prognosis):

If treated promptly, malignant hypertension is often controlled without permanent complications. If it is not treated promptly, complications may be severe and life threatening.

Complications:

• recurrence of malignant hypertension episodes
• damage to the brain from
  • hypertensive encephalopathy
  • spasm or constriction of the arteries of the brain
  • cerebral edema
  • stroke
  • seizures
  • intracerebral hemorrhage
  • coma

• pressure damage to the eyes, permanent blindness
• pressure damage to the heart
  • decreased cardiac output
  • heart attack
  • angina

• pulmonary edema
• acute renal failure

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if symptoms of malignant hypertension develop. This is an emergency condition!

Call your health care provider if known hypertension is poorly controlled.