7. Disease
        Cardiovascular
            Hypertension
Hypertension - Malignant

Hypertension - Malignant

A. Presentation

The fullblown syndrome include

B. Investigation

As per Hypertension.

C. Treatment

Treatment is to aim to limit acute end organ damage.

 

Rapid blood pressure reduction (over several hours) is required in some circumstances  (aortic dissection, severe pre-eclampsia). In other cases, gradual blood pressure reduction over several days is sufficient and usually safer.

 

To reduce blood pressure over several hours, consider:

 

To reduce blood pressure over several days, consider oral antihypertensive drugs, e.g. beta-blockers, ACE-inhibitors, long acting dihydropyridines.

 

Diuretics are NOT suitable because of risk of hypovolemia.

 

Avoid precipitous BP reduction (>20% reduction over 6 hours) to prevent myocardial ischemia, infarction or cerebral hypoperfusion or renal ischaemia/infarction.

 

D. Other notes

5% of hypertensive person have malignant hypertension.

About
Created20031016
Updated20031016


Table of contents  | Bibliography  | Index