Discharge Instructions for Malignant Hypertension

Malignant hypertension is a medical emergency. It means you have dangerously high blood pressure (a top number usually higher than 180 or a bottom number higher than 120). This elevated blood pressure could result in damage to your heart, kidneys, brain, eyes, blood vessels, and other organs. Here’s what you can do to help manage this condition.

Taking your blood pressure

  • Learn to take your own blood pressure.

  • Keep a record of your blood pressure results. Ask your doctor which readings mean that you need medical attention.

  • Have your blood pressure checked by your healthcare provider regularly.

  • If you have a blood pressure measure at home that is higher than 180/110 wait 2 minutes and take it again. If the second reading shows either number at or above the first reading, OR if you have any symptoms shown at the end of this page, seek immediate emergency medical treatment.

Taking medicines

  • Take your blood pressure medicine exactly as your doctor directed. 

  • Learn the possible side effects of any prescribed medicines.

  • Tell your doctor about any medicine you are taking. Some medicines can cause malignant hypertension.

  • Avoid medicines that contain heart stimulants, including over-the-counter drugs. Check for warnings about high blood pressure on the label.

  • Check with your doctor before taking a decongestant. Some can worsen high blood pressure.

Lifestyle changes

  • Limit your activity until your blood pressure is controlled.

  • Cut back on salt.

    • Limit canned, dried, packaged, and fast foods.

    • Don’t add salt to your food at the table.

    • Season foods with herbs instead of salt when you cook.

    • Request foods at restaurants with no added salt.

  • Maintain a healthy weight. Get help to lose any extra pounds.

  • Begin an exercise program. Ask your doctor how to get started. You can benefit from simple activities like walking, gardening, swimming, or dancing.

  • Don’t drink more than 1 alcoholic drink a day for women and 2 a day for men.

  • Limit drinks that contain caffeine (coffee, black or green tea, cola) to 2 per day.

  • Never take stimulants such as amphetamines or cocaine; these drugs can be deadly for someone with hypertension.

  • Control your stress. Learn stress-management techniques.

Follow-up care

  • Make a follow-up appointment with your doctor regularly.

  • Visit your doctor for blood pressure checks, dietary advice, and medicine adjustment.

Call 911

Call 911 if you have any of these:

  • Chest pain or shortness of breath

  • Seizure (with no history of seizure disorder)

When to seek medical care

Call your doctor right away if you have any of the following:

  • Moderate to severe headache

  • Weakness in the muscles of your face, arms, or legs

  • Trouble speaking

  • Extreme drowsiness or confusion

  • Restlessness, anxiety

  • Fainting or dizziness

  • Pulsating or rushing sound in your ears

  • Unexplained nosebleed

  • Weakness, tingling, or numbness of your face, arms, or legs

  • Change in vision (including blurred vision)

  • Unusual tiredness

  • Nausea or vomiting

  • Decreased urine output

  • Blood pressure reading measured at home that is higher than 180/110


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