Malignant Hypertension



This problem can happen when high blood pressure is not managed with medicine. Some other problems that may lead to it are:

  • Kidney disorders or failure
  • Taking some medicines, such as monoamine oxidase inhibitors or birth control pills
  • Using drugs, such as cocaine or amphetamines
  • Being pregnant and having preeclampsia or eclampsia
  • Hormonal problems, such as Cushing disease
  • Spinal cord problems
  • Coarctation of the aorta
  • Narrowing of the arteries to the kidneys

Risk Factors

This problem is more common in older adults, especially men. It is also more common in people who are Black. Other things that may raise the risk are:

  • Heart failure
  • Marijuana use
  • Coronary artery disease
  • Kidney disease
  • High cholesterol



Some people may not have symptoms. Others may have:

  • Headache
  • Nausea and vomiting
  • Eyesight problems
  • Numbness of the legs, arms, or face
  • Problems breathing
  • Chest pain


The doctor will ask about your symptoms and health history. A physical exam will be done. Blood pressure readings will be taken.

These tests may be done to look for damage in the body:

  • Blood and urine tests
  • An electrocardiogram (ECG) to measure the electrical activity in the heart
  • An eye exam to look for swelling or bleeding
  • Images of the body taken with:
    • Chest x-ray
    • CT scan
    • Echocardiogram or ultrasound of the heart to look for heart damage
    • Kidney or bladder ultrasound



This problem needs to be treated right away. Options depend on the damage that has happened.

Medicine will be given to lower blood pressure. It may be given by IV. This lets the medicine quickly lower blood pressure. Options are:

  • Sodium nitroprusside or nitroglycerin
  • Beta-blockers
  • Other vasodilators
  • angiotensin-converting enzyme (ACE)-inhibitor

A care plan will be made to keep blood pressure at a healthy level. Medicine will need to be part of it.


People with high blood pressure can lower the chance of this problem by checking their blood pressure often and taking medicine to lower it.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.