Malignant Hypertension

Abstract

Malignant hypertension is defined by a rise in blood pressure associated with stage III or IV retinopathy. This situation remains rare but may have a fatal issue if not recognized and treated appropriately. The understanding of the pathogenesis of malignant hypertension with the importance of renin angiotensin aldosteron system activation allowed for an improvement in early and long term outcomes. The key point is to determine whether the rise in blood pressure is associated with organ failure or not, to differentiate hypertensive urgencies from emergencies. In hypertensive emergencies, the rapid introduction of antihypertensive drugs is recommended. The aim of this review is to propose guidance for malignant hypertension diagnosis, cause assessment, and treatment.