Is there any difference between malignant hypertension and accelarated hypertension? India

July 21, 2009

Is there any difference between malignant hypertension and accelarated hypertension?

It is the same thing!!
Malignant or accelarated hypertension is a life-threatening medical emergency that is a possible complication of practically any hypertensive disorder. If not promptly treated it can cause severe, rapidly progressive target-organ damage and death. While the histo-pathologic features of malignant hypertension are well recognized, the pathogenesis of the associated vascular lesions and the transition from a benign to a malignant phase are unclear. With adequate control of hypertension, progression to the accelarated or malignant phase can be prevented. Moreover, promptly and effectively reducing the blood pressure during the malignant phase can prevent, minimize or even reverse serious target organ injury. Malignant hypertension, therefore, is both preventable and treatable.

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5 Responses to “Is there any difference between malignant hypertension and accelarated hypertension? India”

  1. admin on July 21st, 2009 11:10 pm
    Accelerated or malignant hypertension(synonyms) is a severe form of acute hypertension that results in the abrupt rise in the blood pressure (diastolic pressure often over 120 mmHg).
    Hypertensive emergency is a condition in which elevated blood pressure results in target organ damage. The systems primarily involved include the central nervous system, the cardiovascular system, and the kidneys.
    • Malignant hypertension and accelerated hypertension are both hypertensive emergencies, with similar outcomes and therapies.
    • In order to diagnose malignant hypertension, papilledema must be present.
    • Accelerated hypertension is defined as a recent significant increase over baseline blood pressure that is associated with target organ damage. This is usually vascular damage on funduscopic examination, such as flame-shaped hemorrhages or soft exudates, but without papilledema.

    (Papilledema is an optic disc swelling that is secondary to elevated intracranial pressure).

  2. admin on July 21st, 2009 11:10 pm
    Accelerated hypertension is the term, now synonymous with malignant hypertension, currently used to describe severe hypertension (=180mmHg systolic and =110mmHg diastolic) occurring with retinopathy of Grade III (flame haemorrhages, dot and blot haemorrhages, hard and soft exudates) to Grade IV (papilloedema).
  3. admin on July 21st, 2009 11:10 pm
    They're generally used interchangeably, though some make a fine point of degree, but the main point is that the level of elevation is not part of the diagnosis; rather, acute end-organ damage is needed for the diagnosis.
  4. admin on July 21st, 2009 11:10 pm
    Not as regards the causal mechanism, which is excessve systolic pressure due to excessive pulse pressure being superimposed upon already hypertensive mean arterial pressure. The excessive peak pulse pressures in turn, are induced by aberrently high ratio of stroke volumes to pulse rates configured by the brain, to produce any required cardiac output (CO = N x Vs). The cause is unknown, but the excessive Vs/N ratio is present in all forms of hypertension, including malignant, but also pre-eclampsia, primary, secondary,and especially, so-called 'isolated', manifesting itself by excessively high pulse pressre to pulse rate ratios.

    Pulse pressure (in the left ventricle) is directly proportional to stroke volume, so excessive stroke volumes result in excessive pulse pressures, and since systolic pressure is the sum of mean- and pulse- pressures, potentially-fatal excessive systolics result.
    It's exactly the same mechanism that causes flash-over peaks in voltage in electric cables.
    Note: Ps = N.Vs.Z + 2Pp/3, where Ps is systolic, N = pulse rate, Vs = stroke volume, Z, total peripheral impedance, and Pp = pulse pressure.

  5. admin on July 21st, 2009 11:10 pm
    Severe hypertension that runs a rapid course and damages the inner linings of the blood vessels and the heart and spleen and kidneys and brain; "malignant hypertension is the most lethal form of hypertension". Sometimes malignant hypertension is also termed as acclerated hypertension.

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