Malignant Hypertension

Malignant hypertension is a term that has been used to describe patients with elevated blood pressure (BP) and multiple complications (End organ damage) with a poor prognosis. Today, the term hypertensive crisis is used to describe patients who present with severe BP elevations as follow:

1. Systolic blood pressure (SBP) greater than 180 mm Hg

2. Diastolic blood pressure (DBP) greater than 120 mm Hg)

The diagnosis can be further classified as a hypertensive emergency when severe elevation in BP is associated with end-organ damage or hypertensive urgency when severe hypertension occurs without it. Prompt treatment of BP can prevent a hypertensive emergency and, consequently, serious life-threatening complications.

To make a diagnosis of malignant hypertension, papilledema has to be present. In malignant hypertension, the key is to lower the blood pressure within a few hours.