3 Ways to Treat Malignant Hypertension

2024 Author: Samantha Chapman | [email protected]. Last modified: 2023-12-17 09:13

Malignant hypertension (the rapid onset of high blood pressure with an acute effect on one or more organs) is not something you hear about every day. However, it is a very serious state and is considered a medical emergency. If you suspect that you or someone you know has malignant hypertension, go to the nearest hospital as soon as possible. Among the treatments there is an immediate and aggressive antihypertensive therapy, before there is irreversible damage to the brain, eyes, blood vessels, heart and kidneys.

Steps

Method 1 of 3: Adopt Ongoing Medical Care

Step 1. Take enalaprilat to keep blood vessels relaxed

This drug helps relieve malignant hypertension by relaxing the blood vessels.

It works by preventing an enzyme in the body from producing angiotensin II, a substance that can constrict blood vessels and release hormones that cause high blood pressure.
Enalaprilat is the intravenous form of the ACE inhibitor enalapril (angiotensin converting enzyme).
This drug has been found to be effective for treating malignant hypertension, especially for those suffering from left-sided heart failure.
The dosage is 1.25 mg every 6 hours.

Step 2. Try labetalol to block the effects of epinephrine and adrenaline

If you've had a myocardial infarction or angina, use labetalol to keep your heart rate from rising.

Labetalol is a beta blocker, a medicine that can block the effects of epinephrine and adrenaline.
The result is that the heart beats slower and with less force, lowering blood pressure.

Step 3. Labetalol can also dilate or open blood vessels, improving blood flow

Note that this medicine may be ineffective for those who have used beta blockers before.
Anyone with heart failure, asthma, or brachycardia should not use this drug.
This drug is administered intravenously or orally.
The dosage is 20 to 80 mg every 10 minutes. The daily dosage should not exceed 300 mg.

Step 4. Look for hydralazine to open blood vessels

Hydralazine is a vasodilator that works in 10 minutes.

Hydralazine widens blood vessels and improves blood flow.
The recommended dose is 10 mg intravenously every 10-15 minutes until blood pressure decreases.
Note that the dosage should not exceed 50 mg.

Step 5. Try nifedipine to increase cardiac efficiency

Nifedipine is a calcium channel blocker, a drug that can relax blood vessels and promote a faster heartbeat without the heart pumping too hard.

This drug is useful, but it can cause rapid heartbeat (a dangerous increase in the heart rate).
The dosage of nifedipine is 10 to 20 mg, administered every 3-6 hours.

Step 6. Use furosemide to lower blood pressure

Furosemide is a diuretic, which can eliminate the presence of salt and water from the body.

It works by blocking the reabsorption of salt and water from the filtered fluids found in the kidneys, causing an increase in urine production.
Lasix can be given orally or intravenously.
This drug is also given to counteract sensitivity to other drugs used for hypertension.
The dosage is usually 1 tablet of 40-80 mg per day.

Step 7. Do dialysis to counteract the failing kidneys

In the presence of failing kidneys, dialysis may be necessary to filter the blood of toxins and other substances.

Dialysis is done to reduce the presence of extracellular fluid and to help promote blood pressure control and improve kidney function

Step 8. Undergo surgery to manage long-term hypertension

Bilateral nephrectomy, or surgical removal of the kidneys, can help manage hypertension.

If you undergo this treatment, your blood will be kept through long-term dialysis.
In some cases, you may be a candidate for kidney replacement.
This surgical procedure is avoided as much as possible, because it can lead to a loss of erythropoietin (a glycoprotein hormone synthesized by the kidneys) which then leads to anemia.
Bilateral nephrectomy can also affect the body's vitamin D dosage.

Method 2 of 3: Get Immediate Medical Care

Step 1. Stay in the hospital until your blood pressure has stabilized

After you are diagnosed with malignant hypertension, you will need to stay in the hospital until your extremely high blood pressure is under control.

Normally, patients are admitted to the intensive care unit, so that the functions of the heart, brain and urine are continuously monitored.
Activity is usually limited to total bed rest, without being able to go to the bathroom until stable.
Continuous monitoring is important to prevent the pressure from rising out of control.
An intra-arterial branch (tube in the artery) is usually used to continuously monitor blood pressure.
These precautions will help avoid life-threatening complications.
Normal activities can be resumed once blood pressure has been checked.

Step 2. Lower your blood pressure in 24-48 hours to make sure your organs have enough blood

Try to reduce your blood pressure gradually and safely over the course of 24 to 48 hours, rather than taking drastic action with medications.

Care should always be taken not to drop blood pressure too quickly, as this could lead to hypoperfusion (lack of adequate blood flow) of the organs, creating damage to the organs.
The kidneys are extremely vulnerable to hypoperfusion and should be monitored closely.
Reduce your blood pressure to 110mmHg diastolic (the bottom value of your blood pressure reading) over the course of 4 hours.
If blood volume or sodium levels drop, take fluids such as isotonic sodium chloride solution.

Step 3. Take nitroprusside to dilate blood vessels and increase flow

Nitroprusside is a vasodilator, a kind of drug used to dilate or open blood vessels.

This drug works directly on the muscle walls of the arteries, to prevent them from stiffening and narrowing, leading to a continuous and fluid flow of blood.
The blood pressure is then reduced and the heart pumps with less power.

Step 4. Nitroprusside is given by intravenous solution in a dose between 0.25 and 8.0 µg / kg / min

This is actually the drug of choice to treat malignant hypertension, because it can dilate arteries and veins.
This drug can be used for days with minimal side effects.

Step 5. Try nitroglycerin to open the arteries

Nitroglycerin is another vasodilator, but it affects veins more than arteries.

This drug is effective for those with hypertension due to medical conditions such as coronary bypass surgery, left heart failure, myocardial infarction, and unstable angina pectoris.
This nitroglycerin is administered by continuous infusion at a rate of 5 to 100 µg / min.

Step 6. Look for diazoxide to improve arterial tone

Diazoxide mainly affects arterial tone and is able to reduce high blood pressure and decrease the fluid build-up in the kidneys.

Diazoxide reduces the ability of the kidneys to reabsorb salt and water in the urine, resulting in more urine production.
Diazoxide is an easy drug to administer, but it is less effective than others.
It is administered in a dosage of 50 to 150 mg.
It takes effect in 1-5 minutes. When needed, the same dose can be repeated for 5 to 10 minutes if blood pressure rises.
Remember that the total dose should not exceed 600 mg / d.

Step 7. Take trimetaphane to reduce heart rate

Trimetaphane is a ganglionic blocker, a type of drug that reduces the heart rate by decreasing the pumping force of the blood.

This drug is given at a rate of 0.5 to 5 mg / min.
It is a drug rarely used today.
Trimetaphane is best taken while sitting with blood pressure constantly monitored.

Method 3 of 3: Coping with Lifestyle Changes

Step 1. Maintain a low sodium diet to reduce blood pressure

A low sodium diet is recommended to keep blood pressure low.

Salt (sodium) causes water retention and increased blood pressure, because the blood volume increases and the arteries near the kidneys have to work harder to remove excess water.
A low sodium diet consists of fresh fruits and vegetables, because this food is naturally low in salt.
Avoid buying canned foods, they contain salt to preserve color and keep food fresh.
Avoid processed foods such as meat, which is high in sodium.

Step 2. Eat low-fat, low-cholesterol foods to maintain good cholesterol levels

Having a low-cholesterol, low-fat diet will improve heart health by keeping blood vessels free from blockages and plaques.

A low-fat, low-cholesterol diet will likely be high in fiber.
It is best to eat oats, brown rice, and pasta.
All types of raw fruits and vegetables are low in fat and cholesterol.
Dried beans, lentils, and baked or boiled potatoes can also be included in this diet.
A normal cholesterol level ranges from 122 to 200 mg / dL, while a normal triglyceride level ranges from 37 to 286 mg / dL.

Step 3. Practice to improve heart function

Although activity will be limited until you leave the hospital, you can resume normal activities and exercises once your blood pressure has stabilized.

You should exercise for a minimum of 30 minutes a day once the pressure is stable.
Practice with moderate intensity 3 to 5 days a week.
The activity should consist mainly of aerobic or resistance exercises, with some power training.
Regular exercise makes the heart stronger and able to pump more blood with less effort.
This means that the heart works less and puts less force on the arteries, lowering blood pressure.

Step 4. Stop smoking to lower your blood pressure

Smoking decreases the amount of oxygen that goes to the heart, increases blood pressure and heart rate, increases blood clotting, and damages the cells that make up the coronary arteries and other blood vessels.

It can be difficult to quit smoking, but it's a great option for staying healthy.
If you are a smoker, you are more prone to have high blood pressure, which could lead to malignant hypertension.
Consult your doctor, he can help you break the habit with the help of medications and counseling.

Step 5. Reduce alcohol intake to lower systolic blood pressure

Heavy drinkers who decrease alcohol can lower systolic blood pressure (the top number in the blood pressure reading) by 2 to 4 millimeters of mercury (mm Hg) and diastolic blood pressure (the bottom number in the blood pressure reading) from 1 to 2 mm Hg.

Limit your alcohol intake to 2 drinks per day for men, 1 for women, or those over 65.
If you are an alcoholic, you should consider Alcoholics Anonymous or seek help from your doctor or psychologist.