What is the definition of Malignant Hypertension?

Malignant hypertension is very high blood pressure that comes on suddenly and quickly.

What are the alternative names for Malignant Hypertension?

Accelerated hypertension; Arteriolar nephrosclerosis; Nephrosclerosis - arteriolar; Hypertension - malignant; High blood pressure - malignant

What are the causes for Malignant Hypertension?

The disorder affects a small number of people with high blood pressure, including children and adults. It is more common in younger adults, especially African American men.

It also occurs in people with:

  • Collagen vascular disorders (such as systemic lupus erythematosus, systemic sclerosis, and periarteritis nodosa)
  • Kidney problems
  • Pregnancy-induced high blood pressure (toxemia)

You are at high risk for malignant hypertension if you smoke and if you have had:

  • Kidney failure
  • Renal hypertension caused by renal artery stenosis

What are the symptoms for Malignant Hypertension?

Symptoms of malignant hypertension include:

  • Blurred vision
  • Change in mental status, such as anxiety, confusion, decreased alertness, decreased ability to concentrate, fatigue, restlessness, sleepiness, or stupor
  • Chest pain (feeling of crushing or pressure)
  • Cough
  • Headache
  • Nausea or vomiting
  • Numbness of the arms, legs, face, or other areas
  • Reduced urine output
  • Seizure
  • Shortness of breath
  • Weakness of the arms, legs, face, or other areas

What are the current treatments for Malignant Hypertension?

You will need to stay in the hospital until your severe high blood pressure is under control. You will receive medicines through a vein (IV) to reduce your blood pressure.

If there is fluid in your lungs, you will be given medicines called diuretics, which help the body remove fluid. Your doctor may give you medicines to protect your heart if you have signs of heart damage.

After your severe high blood pressure is under control, blood pressure medicines taken by mouth can control blood pressure. Your medicine may need to be changed sometimes. High blood pressure can be difficult to control.

What is the outlook (prognosis) for Malignant Hypertension?

Many body systems are at serious risk from the extreme rise in blood pressure. Organs including the brain, eyes, blood vessels, heart, and kidneys may be damaged.

The blood vessels of the kidney are very likely to be damaged by high blood pressure. Kidney failure may develop, which may be permanent. If this happens, you may need dialysis (machine that removes waste products from blood).

If treated right away, malignant hypertension can often be controlled without causing permanent problems. If it is not treated right away, it can be fatal.

What are the possible complications for Malignant Hypertension?

These complications may occur:

  • Brain damage (stroke, seizures)
  • Heart damage, including: heart attack, angina (chest pain due to narrowed blood vessels or weakened heart muscle), heart rhythm disturbances
  • Kidney failure
  • Permanent blindness
  • Fluid in the lungs

When should I contact a medical professional for Malignant Hypertension?

Go to the emergency room or call your local emergency number (such as 911) if you have symptoms of malignant hypertension. This is an emergency condition that can be life threatening.

Call your health care provider if you know you have poorly controlled high blood pressure.

How do I prevent Malignant Hypertension?

If you have high blood pressure, carefully monitor your blood pressure and take your medicines properly to help reduce your risk. Eat a healthy diet that is low in salt and fat.



Bansal S, Linas SL. Hypertensive crisis: emergency and urgency. In: Vincent J-L, Abraham E, Moore FA, Kochanek PM, Fink MP, eds. Textbook of Critical Care. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 87.

Greco BA, Umanath K. Renovascular hypertension and ischemic nephropathy. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 41.

Kaynar AM. Arterial blood gas interpretation. In: Vincent J-L, Abraham E, Moore FA, Kochanek PM, Fink MP, eds. Textbook of Critical Care. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 36.

Levy PD, Brody A. Hypertension. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 74.

  • Condition: Malignant Hypertension with Splenic Rupture and Thrombotic Microangiopathy
  • Journal: Medicine
  • Treatment Used: Hemodialysis and Intravenous Antihypertensive Agents
  • Number of Patients: 1
  • Published —
This case report describes a patient with malignant hypertension with splenic rupture and thrombotic microangiopathy that was treated using hemodialysis and intravenous antihypertensive agents.
  • Condition: Takayasu Arteritis-induced Renal Arteritis
  • Journal: Chinese medical journal
  • Treatment Used: Various
  • Number of Patients: 82
  • Published —
In this review of the literature, researchers sought to determine the best treatments for Takayasu arteritis-induced renal arteritis.
Clinical Trial
  • Status: Recruiting
  • Intervention Type: Diagnostic Test, Device
  • Participants: 300
  • Start Date: February 1, 2020
The Complex Evaluation of the Cardiovascular Risk in the Kidney Transplant Patients
Clinical Trial
  • Status: Recruiting
  • Participants: 500
  • Start Date: September 20, 2019
A New Breath for Malignant Hypertension: Implementation of the HAMA Cohort