Malignant Hypertension (Hypertensive emergencies, High Blood Pressure)

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Malignant hypertension is very high blood pressure that comes on suddenly and quickly. The lower (diastolic) blood pressure reading, which is normally around 80 mmHg, is often above 130 mmHg. The disorder affects about 1% of people with high blood pressure, including both children and adults. It is more common in younger adults, especially African-American men. It also occurs in people with: Collagen vascular disorders; Kidney problems; Toxemia of pregnancy; You are at high risk for malignant hypertension if you have had: Kidney failure; Renal hypertension caused by renal artery stenosis. Defined as elevated blood pressure (usually systolic blood pressure >210 mmHg and diastolic blood pressure >130 mmHg) with rapid decompensation of vital organ function. If the clinical suspicion is high, treatment should be initiated immediately without waiting for further tests. It has a good prognosis with appropriate treatment. Blood pressure must be lowered over minutes to hours with parenteral medications in an intensive care setting. Oral medications should be given shortly thereafter to permit weaning from parenteral agents. The initial goal of therapy is to reduce mean arterial Blood pressure by no more than 25% (within minutes to 1 hour), then, if stable, to 160-110 to 100 mmHg within the next 2 to 6 hours. Exceptions to this general rule are patients with intracranial pathology and patients with aortic dissection. Excessive falls in pressure that may precipitate renal, cerebral, or coronary ischemia should be avoided.


Laboratory Test Procedures:

blurred vision
concentration difficulties
chest pain
numbness or tingling in the face
numbness or tingling in the hands
numbness or tingling in the feet
decreased urine output
shortness of breath
pain, numbness, weakness or coldness in legs or arms

Basophil %
Basophil Absolute
Protein (URINE TEST)
RBC (erythrocytes) (URINE TEST)
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