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Malignant hypertension (arteriolar nephrosclerosis)

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Definition:

Malignant hypertension is usually defined as very high blood pressure with swelling of the optic nerve behind the eye, called papilledema (grade IV Keith-Wagner hypertensive retinopathy). Malignant hypertension is usually accompanied by other organ damage like heart failure, kidney failure, and hypertensive encephalopathy.

Alternative Names:

Accelerated hypertension; Arteriolar nephrosclerosis; Nephrosclerosis - arteriolar; Hypertension - malignant

Causes, incidence, and risk factors:

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 women with toxemia of pregnancy , and people with kidney disorders or collagen vascular disorders . You are at high risk for malignant hypertension if you have had kidney (renal) failure or renal hypertension caused by renal artery stenosis .

Malignant hypertension is a medical emergency. Many body systems are in serious risk due to the extreme elevation of blood pressure. Multiple organs of the body, including the brain, eyes, blood vessels, heart, and kidneys may sustain damage. The blood vessels of the kidney are highly susceptible to damage caused by pressure, and kidney failure may develop, which may be permanent.

• Review Date: 9/13/2005
• Reviewed By: Robert Mushnick, M.D., Clinical Assistant Professor, SUNY Downstate Health Center, Brooklyn, NY. Review provided by VeriMed Healthcare Network.

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