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Treatment of malignant hypertension. Malignant hypertension: symptoms, etiology, treatment

Malignant hypertension is the most severe stage of hypertension, in which blood pressure is 180/120 mmHg. Art, and in some cases even higher. Very often, such high pressure can result in severe hemorrhages, disruption of the functioning of all organs and systems, changes in the vascular walls, and others. Most often, malignant hypertension occurs after primary arterial hypertension, which is observed more often than the secondary form. The malignant form of the disease often occurs in men at a young age; after 60 years, the percentage of its occurrence decreases significantly.

All diseases have hidden or pronounced symptoms, and malignant hypertension is no exception. All manifestations of the disease can be examined only during the development of the pathological process, because in the initial stages this disease may not manifest itself at all. The first sign of unpleasant changes in the body is a deterioration in health, frequent headaches, which make themselves felt immediately after a change in the usual climate or weather conditions. Most often, headaches are felt in the morning.

Malignant arterial hypertension is characterized by the following symptoms:

Regular increase in pressure, deviations from the norm, even in a calm state. Dizziness, vomiting, nausea, loss of consciousness. Impaired cerebral circulation, impaired memory and attention. Rapid increase in blood pressure with minimal physical activity. Rapid deterioration of vision, which can develop into blindness. General weakness of the body, swelling on the face, sharp loss of body weight. Severe pressing pain in the chest area, which confirms the presence of coronary heart disease. Convulsions, shortness of breath, pale skin.

For each patient, the symptoms may be different, but it is the above listed manifestations that are observed most often. A patient suffering from malignant hypertension has problems sleeping. General weakness, lethargy and apathy to physical activity are present in almost all people who are faced with this problem.

Important to know!

Vessels become dirty very quickly, especially in older people. To do this, you don’t need to eat burgers or fries all day long. It is enough to eat one sausage or scrambled egg for some amount of cholesterol to be deposited in the blood vessels. Over time, pollution accumulates...

It is possible to identify the cause of malignant hypertension, despite the fact that there are a lot of them. Only 2% of diseases remain causeless; in all other cases, the causes are identified with the help of professional specialists. If you can determine the cause of the disease, then it will not be difficult to cure it. Among the main causes of malignant hypertension are the presence of the following diseases:

Renovascular hypertension is a kidney disease during which the kidneys do not receive the required amount of blood, as a result of which their functioning is impaired. In the case when the kidneys do not receive the amount of blood they need, they regard this factor as a sharp decrease in blood pressure, which is why they begin to secrete much more substances that will contribute to an increase in blood pressure. Pheochromocytoma is a tumor of the adrenal medulla, which occurs in almost 50% of patients. Primary aldosteronism is a tumor of the adrenal cortex, which secretes the hormone aldosterone. As a result, there is a sharp increase in blood pressure, which can occur in 10% of people. Diseases of the parenchyma. Renal vascular lesions. Renal etiology. Endocrine diseases.

There are often cases when malignant hypertension occurs due to several diseases simultaneously, in which case its treatment will be much more difficult and lengthy. Only a specialist can determine the causes of the appearance after a preliminary full examination of the patient and determination of the main nuances of the disease. If you find the cause of malignant hypertension in time, you can quickly select suitable treatments and save the patient from such an unpleasant illness that can make life unfulfilling.

IMPORTANT TO KNOW!

In 90-95% of people, high blood pressure develops regardless of lifestyle, being a risk factor for diseases of the brain, kidneys, heart, vision, AS WELL AS HEART ATTACKS AND STROKES! In 2017, scientists discovered a relationship between the mechanisms of increasing blood pressure and blood clotting factor.

To get rid of such a terrible disease as malignant hypertension, it is necessary to seek emergency help from medical personnel. As a rule, the treatment process takes place in the intensive care unit. Initially, a general examination of the patient is carried out, the causes of the disease are determined, and only then treatment for malignant hypertension is prescribed, which is aimed at quickly reducing blood pressure and restoring all lost body functions.

Treatment must begin immediately after certain symptoms have been identified, an examination has been carried out and a diagnosis has been made. Only an experienced doctor will be able to quickly navigate the selection of the necessary medications, as well as in carrying out the necessary measures. Along with inpatient treatment, the doctor can prescribe suitable medications for better results. In order for the drugs to have the most positive effect on the body, it is necessary:

During treatment and in the future, completely stop smoking. Follow a certain diet, which involves taking no more than 3-4 grams of salt per day. Physical activity (daily walking in the fresh air, jogging at a slow pace if possible, swimming). Quitting alcohol.

At the first stage of treatment, in order to reduce blood pressure when it sharply increases, drugs for internal administration can also be used, among them the following can be noted:

Drugs from the group of peripheral vasodilators, which are administered only by the attending physician. Drugs that block the entry of calcium into the blood. They are used when you need to quickly stop a hypertensive crisis. Beta blockers - normalize the heart rate and also significantly reduce blood pressure, bringing it back to normal. Centrally acting drugs - they lower blood pressure by having a direct effect on the brain.

Treatment with one or two drugs will be ineffective; in this case, it is necessary to use several drugs at once, which will complement each other as much as possible and increase the positive effect on the body. Only a professional doctor knows all the nuances of prescribing and using medications. To increase the recovery process, save time and money for treatment, only long-acting drugs are used that actively fight the disease for 24 hours. To ensure proper and regular control of your blood pressure, such medications can only be used once a day.

Malignant arterial hypertension syndrome is treated individually for each patient. There is no one standard treatment method or one drug that will have a positive effect on the body of every patient. All groups of drugs are selected strictly individually, among them the following can be noted:

In order for certain drugs to have a positive effect on a sick body, their dose is calculated strictly individually. By regularly taking prescribed medications, you can quickly reduce diastolic blood pressure to 100-110 mm Hg. Art. There is no need to abuse the prescribed medications and increase the dose in order to lower the blood pressure even more. Remember that an excessively sharp reduction in pressure artificially can lead to such a manifestation as an ischemic stroke. Only with proper and consistent treatment can you really achieve the desired result and get rid of your problem.

Complications due to improper treatment

It is strictly prohibited to treat diseases such as malignant hypertension on your own. Only an experienced specialist will be able to prescribe the necessary course of treatment, select medications for each patient individually, which will have an exclusively positive effect on the body. If you treat the disease incorrectly or do not follow the required dosages, you may encounter the following additional diseases:

This is not a complete list of diseases that can occur as a result of improper treatment of hypertension. In order not to put yourself in danger again and not to provoke the occurrence of other concomitant diseases that can be fatal, you must:

If you notice symptoms of the disease, consult a doctor immediately. Carry out all prescribed actions and take the necessary medications. Follow the diet prescribed by your doctor. Completely give up bad habits, especially during treatment. Establish physical activity.

Not every person knows what malignant hypertension is, which is why in many cases the problem is not immediately recognized. If you experience some of the symptoms described above, you should immediately seek help from a doctor who can identify this disease. Remember, the sooner a problem is identified, the faster and more effectively you can get rid of it and enjoy life in a healthy body.

Initial diagnostic tests for malignant hypertension include a complete blood count and tests of electrolytes (including calcium), blood urea, creatinine levels, glucose, coagulation profile and urinalysis.

Other laboratory tests are prescribed only in accordance with the instructions for therapy. These may include measurements of cardiac enzymes, urinary catecholamines, and thyroid-stimulating hormone.

Kidney function is assessed using a urinalysis, complete chemistry profile, and complete blood count. Expected findings include increased blood urea and creatinine levels, hyperphosphatemia, hyperkalemia or hypokalemia, abnormal glucose metabolism, acidosis, hypernatremia, and evidence of microangiopathic hemolytic anemia and azotemic oliguric renal failure. Urinalysis may reveal proteinuria, microscopic hematuria, and red blood cells or hyaline casts in the urine.

Diffuse intrarenal ischemia results in increased plasma levels of renin, angiotensin II, and aldosterone, leading to hypovolemia and hypokalemia. Sodium imbalances are common and can be dangerous.

In addition, a chest x-ray is obtained, which may be useful in assessing cardiac enlargement, pulmonary edema, or abnormalities of other chest structures, including changes in the ribs due to coarctation of the aorta or widening of the mediastinum due to aortic dissection.

Other tests, including computed tomography (CT) of the head, echocardiography, and renal angiography, are ordered only as directed during initial therapy.

Electrocardiography and echocardiography

Electrocardiography (ECG) is an important diagnostic tool to detect ischemia, infarction, or signs of electrolyte imbalance or drug overdose. In the earliest stages of malignant hypertension, ECG and echocardiography can reveal enlargement of the left atrium and left ventricular hypertrophy.

Treatment

Patients with malignant hypertension are usually referred to the intensive care unit for continuous cardiac monitoring, evaluation of neurological status, and administration of intravenous antihypertensive drugs. Patients, as a rule, use autoregulation of altered blood pressure (BP). Excessive reduction of blood pressure to control levels can lead to organ hypoperfusion.

Hypertension does not require hospitalization. The goal of treatment in these cases is to reduce blood pressure within 24 hours, which can be achieved on an outpatient basis.

Pharmacological therapy

The initial goal of treatment is to reduce mean arterial pressure by approximately 25% during the first two days. An intra-arterial line is useful for continuous BP monitoring. Low sodium levels can be severe, so consider increasing your intake of isotonic sodium chloride solutions. Secondary causes of hypertension should also be investigated.

There are no studies comparing the effectiveness of different drugs in the treatment of malignant hypertension. Drugs are selected based on their speed of action, ease of use, special situations and treatment conditions.

The most commonly used intravenous drug is nitroprusside. An alternative for patients with renal failure is intravenous fenoldopam. Labetalol is another common alternative that provides an easy transition from intravenous to oral administration. However, a clinical trial has shown that intravenous calcium blockers (eg, nicardipine) may be useful in rapidly and safely lowering blood pressure to target levels and appear to be more effective than intravenous labetalol.

Beta blockade can be performed intravenously with esmolol or metoprolol. Diltiazem, verapamil, and enalapril are also available parenterally. Oral medications should be started as soon as possible to facilitate transition to outpatient treatment.

Complications

Correct diagnosis of malignant hypertension is essential for proper treatment; however, reducing blood pressure too quickly can cause harm to the patient. In particular, an excessive decrease in blood pressure can lead to organ hypoperfusion and target organ damage. Please note that enalapril has an unpredictable response in hypovolemic individuals, with a possible uncontrolled decrease in blood pressure.

In addition, all patients should be carefully evaluated for secondary causes of hypertension, and the patient should be closely monitored after discharge. They should be aware of the signs and symptoms that require immediate medical attention.

Diet

Initially, individuals being treated for malignant hypertension are instructed to fast until the condition is stable. Once stabilized, patients are given long-term hypertension management, including a low-salt diet. If necessary, a diet is prescribed, which can lead to weight loss.

Physical activity during the treatment period is limited to bed rest until the patient stabilizes. It should be possible to resume normal activities in an outpatient setting once blood pressure is controlled.

Prevention

The best way to prevent further episodes of hypertension emergencies is to ensure that the patient receives close outpatient monitoring for hypertension treatment. This is usually performed by a primary care physician, but referral to a cardiologist should also be considered for individuals who require multidrug therapy or additional secondary therapy.

Forecast

Before the advent of effective therapy, the life expectancy of people with malignant hypertension was less than 2 years, with most deaths caused by stroke, kidney failure, or heart failure. The survival rate at 1 year was less than 25% and at 5 years it was less than 1%. However, with modern therapy, including dialysis, survival after 1 year exceeds 90%, and after 5 years - 80%. The most common cause of death is cardiovascular, with stroke and kidney failure common.

A British study that looked at 40-year survival rates in 446 patients with malignant hypertension found an even higher 5-year survival rate. The authors determined that before 1977, the 5-year survival rate was 32%, whereas for patients who were diagnosed between 1997 and 2006, the 5-year rate was 91%. The researchers hypothesized that the change was due to lower goals and tighter BP control, as well as the availability of additional classes of antihypertensive medications. The authors also found that age, baseline creatinine, and follow-up systolic blood pressure were independent predictors of survival.

This is a prolonged excessive increase in blood pressure of more than 170/120 mm. rt. Art. in combination with damage to target organs (retina, kidneys, heart and brain). May be complicated by vision loss, stroke, heart or kidney infarction. The clinical picture is often nonspecific and includes dizziness, nausea, vomiting and headaches. The diagnostic program consists of blood pressure monitoring, laboratory methods, ultrasound and CT. Treatment is complex, based on a combination of non-drug and medicinal effects. If necessary, surgical intervention is performed.

ICD-10

I10 I11 I13 I15

General information

Prognosis and prevention

With timely, complete treatment (mainly etiotropic) and good patient compliance, the prognosis is favorable. The overall effectiveness of correction measures depends on the accuracy of diagnosis with determination of the etiology of the underlying disease, the presence or absence of target organ damage, and other associated clinical conditions. Malignant arterial hypertension often develops against the background of existing benign hypertension in the patient. To reduce the risk of deterioration of the condition, it is necessary to adhere to the prescribed therapy while maintaining target blood pressure numbers, observe a sleep and rest schedule, and give up bad habits, especially smoking.

Malignant arterial hypertension is a syndrome of high blood pressure (BP) (over 180 to 120 mm Hg), which leads to serious consequences: visual impairment due to damage to the optic nerve head, ischemia and malfunction of many organs, changes in the walls of blood vessels, which can result in hemorrhages. The form of the disease in which such disorders occur is called malignant arterial hypertension.

The malignant form is quite rare. According to statistics, it is diagnosed in only 1% of patients suffering from hypertension, and is its secondary form.

In most cases, patients with the malignant type are people who manifest hypertension, progressing against the background of renal diseases. Most often these are men under 40 years of age; after this age, the risk of developing this form of the disease decreases.

Arterial hypertension can develop into malignant hypertension for a number of pathological reasons:

Parenchymal kidney diseases;
Renal artery stenosis;
Pathology of the main renal vessels;
Congenital kidney anomalies;
Smoking-induced hypertension;
Kidney cancer.

Due to inflammatory processes developing in the kidneys and adrenal glands, the amount of blood flowing to them decreases sharply, and accordingly, the pressure in the organs drops. Accepting low blood pressure as such, common to the entire body, the kidneys begin to secrete active substances that cause blood pressure to rise rapidly.

In addition to kidney damage, endocrine disorders can affect the development of pathology. In women, they can occur due to long-term use of contraceptives, in late pregnancy or in the postpartum period.

Heredity is of great importance in the development of a malignant form of arterial hypertension. Although this disease is not genetically transmitted, certain vascular and renal pathologies have this ability.

The disease is more severe in people who have several risk factors at once.

Signs and symptoms of the disease

When symptoms of malignant hypertension develop, treatment methods will depend on the effects of high blood pressure on the organs.

At an early stage, the disease can proceed secretly and not manifest itself for some time. Further symptoms appear suddenly and rapidly increase. One of the first and most common is a constant headache in the occipital and frontal parts of the skull, which intensifies in the morning. Often malignant hypertension is accompanied by neurological disorders that occur against the background of arterial thrombosis or hemorrhages in the brain.

The disease is also accompanied by the following unpleasant sensations:

general weakness of the body, sudden weight loss, swelling of the face, which is associated with kidney damage;
dizziness, nausea, vomiting, double vision and blurred vision, loss of consciousness that develops as a result of high blood pressure;
stable hypertension and absence of periods of decreased blood pressure even at night;
a rapid increase in blood pressure in the shortest possible time leads to damage to internal organs;
visual impairment due to deformation of the optic nerve head; numerous hemorrhages and exudates are visible on the retina. Sometimes there is complete blindness;
anemia occurs, which manifests itself in dry and pale skin, body temperature is steadily lowered;
pressing pain in the chest that goes away after taking nitroglycerin;
Impaired cerebral circulation leads to a person’s memory loss or weakening and the ability to concentrate.

It is important not to ignore the manifestations of such symptoms and consult a doctor in a timely manner to avoid irreversible consequences.

Diagnostic measures

To identify the problem, the therapist first listens to the patient’s complaints and collects an anamnesis.

At the appointment, the patient tells the doctor about the factors that could provoke high blood pressure, whether he has relatives with hypertension, and whether he took any medications.

weighs body weight, measures waist and hip circumference;
determines the shade of the skin, the presence of edema;
measures pressure in the upper and lower extremities;
listens to the heart and large vessels using a stethoscope and phonendoscope.

The second stage is to conduct instrumental and laboratory studies, which involve the following diagnostic measures:

General and biochemical blood tests to assess the condition of the kidneys and other possible complications;
General urine analysis, measurement of daily diuresis;
Electrocardiogram assessing cardiac damage;
Daily blood pressure monitoring, which will help identify the activation of hypertension in a certain period of time;
Ultrasound of the kidneys, adrenal glands and thyroid gland;
Vascular ultrasound;
Analysis of hormone levels in the blood.

Since the malignant disease has a wide etiology, it is imperative to consult with specialized specialists (ophthalmologist, nephrologist, endocrinologist, cardiologist, neurologist).

Health implications

Complications of high blood pressure due to malignant hypertension include:

Stroke is the most common consequence of the disease, which leads to disability and death.
Loss of vision occurs due to retinal detachment, hemorrhages (due to increased intracranial pressure), and damage to the optic nerve.
Cardiac ischemia develops when there is insufficient blood supply to the heart muscle. As a result, disorders such as angina pectoris, heart attack, heart failure, and heart rhythm disturbances appear.
Pathologies in the blood supply to the kidneys. Violation of pressure leads to the development of necrosis or infarction, which provoke renal failure. The functionality of natural filters is disrupted, and the body becomes unable to cleanse itself of toxins.

Today, thanks to the discovery of new treatment methods, 90% of patients suffering from malignant hypertension live more than 5 years. If therapy is not started in a timely manner, the prognosis is less favorable. If nothing is done, the person dies after 6 months. The main cause of death in hypertensive patients is stroke; less commonly, death occurs due to heart and kidney failure.

Treatment

Treatment of malignant arterial hypertension is carried out in a hospital setting. The main tasks that doctors initially set for themselves are lowering blood pressure and preventing complications. After normalizing the tonometer readings, they begin to eliminate the main factors causing high blood pressure. If the cause is narrowing of blood vessels or a tumor, then surgical treatment is performed.

The main groups of drugs that are used for hypertensive crisis:

Beta blockers – also reduce heart rate;
Vasodilators – dilate blood vessels;
Ganglion blockers - act on the brain, reducing pressure.

For patients with a malignant form of pathology, in order to achieve a positive result, all groups of these drugs are prescribed simultaneously. The doctor selects the dosage based on the patient’s age, severity of the disease and associated complications. Treatment is effective if the upper pressure has decreased by a third, and the lower pressure by 10-15 units.

In combination with drug therapy, the patient must adhere to certain recommendations:

Bring body weight back to normal;
Follow a diet that limits salt, fatty and fried foods, and increases the intake of potassium, magnesium, and calcium;
Completely eliminate bad habits (alcohol, smoking).
Try to move more.

Some patients resort to traditional methods of treatment. However, you need to remember that it will not be possible to correct the problem in this way. It is useful to include alternative medicine in therapy, as they have a general strengthening effect and can promote recovery. Among the berries that reduce blood pressure and strengthen the body are cranberry, lingonberry, and rowan. Carrot and beet juices also normalize metabolism.

The malignant form of hypertension is understood as a type of disease in which the systolic pressure exceeds 220 mmHg. Art., diastolic – 125 mm Hg. Art., swelling of the optic nerve develops, exudate appears in the fundus. With malignant hypertension, the patient experiences increased dysfunction of the heart, brain and kidneys. Information about what a malignant variant of hypertension is is important for everyone who suffers from high blood pressure.

Concept of malignant hypertension

The disease is quite rare. It affects approximately 1% of patients suffering from high blood pressure. Mostly, malignant hypertension occurs in people who have not treated the disease. Often a malignant form of pathology develops as a secondary disease.

Men under 40 years of age are susceptible to pathology. After 60 years, the risk of getting sick decreases to almost zero. Malignant hypertension occurs against the background of glomerulonephritis and renal pathologies. Most patients do not know what it is - malignant hypertension and do not contact a specialist if they find persistently elevated blood pressure. This aggravates the treatment and prognosis of the pathology.

Causes of the malignant form of hypertension

The disease can develop into a malignant form during its development. The exact causes of the development of the disease have not yet been determined. It has been established that the trigger mechanism for the malignancy of the disease is destructive processes in the cardiovascular system. The most likely cause of the development of pathology is considered to be stenosis (narrowing) of the renal arterial vessels.

Damaged kidneys produce a number of substances that are dangerous to the body. These substances contribute to a constant increase in blood pressure. In this situation, the production of hormones that dilate blood vessels is disrupted.

Malignant hypertension develops as a result of the following pathologies:

Pheochromocytoma, or inflammatory processes in the tissues of the adrenal glands. As a result of these processes, substances are formed in the organ that cause a sharp and stable increase in blood pressure. The probability of developing malignant hypertension against the background of pheochromocytoma is about 50%.
Parenchymal pathologies of the kidneys.
. This is the name for a disorder of the blood vessels in the kidneys. The blood supply to the organ is gradually disrupted, and the blood flow to it decreases. The pressure in the kidneys decreases, they release toxic substances in large quantities.

The following risk factors for the development of degeneration of benign hypertension into malignant hypertension are identified:

. Because of this addiction, the ability of blood vessels to expand and contract is impaired. All smokers are at risk of developing a malignant form of hypertension.
Drinking alcohol. This substance causes sharp fluctuations in blood pressure. This negatively affects the condition of the heart and blood vessels. Ethanol causes damage to all organs. It is important for patients at risk to completely abstain from drinking any types of alcoholic beverages.
Endocrine disorders.
Pregnancy. Malignant arterial hypertension can occur in women in the later stages of pregnancy.
Unfavorable genetic inheritance. A person is at high risk of developing hypertension if his relatives suffered from constant high blood pressure.
Intense physical activity and overwork can cause a permanent increase in blood pressure. This is due to the fact that the body cannot rest adequately, which is why its blood vessels are constantly in a tense state.
Stress, psychological problems and emotional overload contribute to an increase in blood pressure. In some cases, they remain elevated for a long time.
Age factors.

Important! The presence of at least one predisposing factor contributes to the development of a malignant form of hypertension in a patient.

Signs of illness

Its insidiousness is that it may not appear in the early stages. A person may find that he becomes tired more often and quickly, and he cannot perform the same amount of work. However, it is difficult to determine whether a patient has a malignant form of hypertension based on this sign alone. A person begins to use drugs to support the immune system, strengthening compounds. They do not affect slowly progressive hypertension.

As the disease develops, it signals the following signs:

double vision and blurred vision;
blurred vision;
the appearance of sudden and severe pain in the head area of varying degrees of intensity;
severe weakness, combined with a sharp drop in labor productivity;
sudden weight loss (provided that the person’s daily diet does not change);
development of swelling (as a result of dysfunction of the kidneys and adrenal cortex);
the occurrence of syncope;
temporary complete loss of vision;
disruption of normal blood circulation, which manifests itself in a feeling of constant cold (or heat) in the extremities;
a bleeding disorder (which leads to an increased risk of blood clots);
nausea, vomiting, dyspeptic symptoms;
sharp;
jumps in body temperature;
the appearance of pain in the chest (they intensify after physical activity);
problems falling asleep;
change in complexion (malignant arterial hypertension leads to the fact that it becomes gray, sallow);
decreased memory and concentration, other symptoms of disorders of higher nervous activity;
uncontrolled increase in tonometer readings without signs of self-limiting arterial crisis;
enlargement of the abdomen as a result of edema.

Pay attention! The appearance of at least one of the symptoms described above is an indication for immediate consultation with a doctor and a set of diagnostic measures.

Features of disease diagnosis

The specialist must send the patient for examination if signs of a malignant course of hypertension appear.

The most important stage of diagnosis is collecting anamnesis. It helps to clarify the characteristics of a person’s lifestyle and the duration of the pathology. To clarify the diagnosis, the doctor conducts a visual examination of the patient and measures blood pressure. An increase in systolic and diastolic values above 110 mm indicates a high probability of malignancy of arterial hypertension.

The following diagnostic methods are clinically important:

blood tests - general and biochemical;
electrocardiography;
ultrasound examination of the esophagus, stomach and duodenum;
ultrasound examination of the thyroid gland and heart;
ultrasound examination of the retroperitoneal space;
computed tomography or magnetic resonance imaging (possibly using a contrast agent);
daily monitoring of urine output;
echocardiography;
daily blood pressure measurement;
lung capacity test.

The patient needs consultation with an ophthalmologist, cardiologist, neurologist, nephrologist, endocrinologist. Subspecialty specialists detect disorders that develop against the background of a malignant course of hypertension.

Treatment

This form of pathology develops extremely quickly. Treatment of malignant hypertension should begin from the first days of detection of a dangerous pathology. This will prevent the development of dangerous complications that affect all internal organs. Therapy for the malignant form of hypertension begins with eliminating its cause.

Drug treatment

An obligatory part of the treatment of a malignant form of hypertension is taking medications. The doctor prescribes several medications with similar effects. The patient is prescribed drugs of the following groups:

diuretics (diuretics);
beta blockers;
neurotropic and psychotropic drugs;
ganglion blockers;
sympatholytic agents;
vasodilators.

Before choosing a drug, the doctor assesses the degree of development of the pathological process and the nature of the increase in blood pressure. Kidney function, heart rate and its correctness should be taken into account. The criterion for the effectiveness of antihypertensive treatment is a decrease in tonometer readings by ¼ of the current ones.

If by that time the person does not develop adverse reactions to the medications he is taking, and does not experience a deterioration in his health, then he can begin to further lower blood pressure levels.

Treatment of the malignant form of hypertension is associated with avoiding the risk of developing damage to other organs. For this purpose, the patient’s treatment regimen will consist of the following medications:

ACE inhibitors;
calcium antagonists;
beta blockers;
diuretics;
calcium channel blockers.

If necessary, treatment is supplemented with other methods. So, with the development of renal failure, the patient undergoes hemodialysis or hemofiltration. For severe edema, isolated renal ultrafiltration is used. If these methods are ineffective, then the issue of kidney transplantation is decided.

Non-drug therapy

The use of medications alone often does not bring the desired effects. Therefore, it is necessary to introduce other methods of therapy. Its principles are quite simple:

correction of body weight;
consumption of calcium, magnesium and potassium - minerals necessary for the normal functioning of the heart and blood vessels;
quitting smoking and drinking alcoholic beverages;
limiting the consumption of animal fats;
correction of motor activity.

Important! If these treatment methods do not improve the patient’s condition, the issue of surgical treatment of the disease is decided. The most commonly prescribed procedure is coronary artery bypass grafting. If there are tumors of the kidneys, thyroid gland, or adrenal glands, they are resected.

Consequences of the malignant form

If he does not treat his illness or does it incorrectly, he may develop such life-threatening complications.

Apoplexy (stroke). It is the most common consequence of the disease. A stroke leads to patient disability and often death.
Blindness. It develops due to detachment of the retina of the eye. The patient may also lose vision due to progressive damage to the optic nerve.
Impaired blood supply to the kidneys. This complication can cause infarction or organ necrosis. These conditions lead to the development of acute and chronic kidney failure.
Coronary heart disease, which develops against the background of a decrease in blood supply to the heart muscle. It leads to the development of myocardial infarction in the patient.

Pathology prognosis

Doctors are trying to develop and implement therapy methods that would reduce the likelihood of a patient developing severe complications. Current therapeutic methods allow patients to live for more than 5 years with an unfavorable prognosis.

Attention! In the absence of professional help, patients develop acute heart and kidney failure. In this case, death is possible within six months. 20% of these patients risk dying within one year from the onset of the pathology without adequate therapy.

Recovery is determined by the timeliness and effectiveness of antihypertensive treatment. The earlier treatment is started, the better the outcome and the higher the likelihood of maintaining a person’s ability to work. A favorable outcome is guaranteed in approximately 90% of cases, provided that effective treatment of the pathology is started early and the patient follows all medical recommendations.

Prevention

Prevention is aimed at a general decline in the body, eliminating the impact of predisposing factors on it and normalizing blood pressure. Preventive measures include:

combating obesity;
normalization of glycemic levels;
treatment of concomitant pathologies;
quitting smoking and drinking alcohol;
constant monitoring of blood pressure indicators;
taking medications prescribed by a doctor to correct tonometer readings.

Malignant hypertension is a dangerous form of the disease. It requires timely treatment and the patient’s compliance with all recommendations regarding a healthy lifestyle. This promotes recovery and prevents the development of dangerous complications.