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Complications of Uncontrolled Hypertension

Drotumdi O

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Otumdi Omekara, MD., MPAHA - Member of Society of Physician Entrepreneurs

Blood Pressure Ranges 

 Normal – Systolic BP < 120 / Diastolic BP < 80 mmHg 

 Prehypertension – Systolic BP 120 – 139 / Diastolic BP 80 – 89 mmHg 

 Stage 1 Hypertension – Systolic BP 140 – 159 / Diastolic BP 90 – 99 mmHg 

 Stage 2 Hypertension – Systolic BP > 160 / Diastolic BP > 100 mmHg 

 Hypertensive Crisis – Systolic BP > 210 / Diastolic BP > 120 mmHg 

Complications of uncontrolled hypertension affect almost all the major organs of the body, especially when it graduates to hypertensive crisis. 

 Head and Neck 

 - Rupture of cerebral blood vessels (cerebrovascular accidents) usually involving berry aneurysms at the base of the brain 

 - Stroke from bleeding or ischemia (insufficient blood supply) 

 - Aortic Dissection – separation of the innermost and middle layers of the aorta by the influx of blood under high   

pressure, through a tear or ulceration of the endothelial plaque 

 - Papilledema – swelling of the optic disk in the eyes due to raised intracranial pressure, with the potential to cause sudden blindness 

Heart 

 - Heart Attack (Acute Coronary Syndrome) due to the narrowing of the coronary arteries supplying blood to the heart as a consequence of aortic dissection 

 - Congestive Heart Failure (CHF) occurs as the heart becomes unable to pump blood adequately against the very high pressure build up 

 Kidneys 

 - Kidney failure occurs especially with the dissection of abdominal aorta in the area of the exit of the renal artery 

 - Mild leakage of protein (proteinuria) and blood (hematuria) into the urine occurs with mild narrowing of the renal arteries 

 - Acute renal failure occurs with moderate narrowing of the renal arteries 

 - Renal crisis occurs with complete occlusion of the renal arteries 

 - Encephalopathy (brain toxicity) occurs from the accumulation of ammonia and its intermediate products in the blood circulating in the brain 

 Skin and Blood 

 Skin damage (scleroderma) and 

 – Acute anemia due to red blood cell damage with thin the blood vessels (microangiopathic hemolysis) also occurs during hypertensive crisis 

These complications all call for urgent or emergency care at the ER. Regular BP monitoring at home and during provider visits helps to prevent hypertension from reaching the crisis point. ER doctors have effective drugs like nitroprusside; nitroglycerine, labetalol, hydrallazine and phentolamine that combine very well to quickly knock down BP below the crisis point. Take the regular BP medications as instructed is very important to keep it under to control after it has been stabilized. 

Otumdi Omekara, MD., MPAHA

Blood Pressure Ranges 

 Normal – Systolic BP < 120 / Diastolic BP < 80 mmHg 

 Prehypertension – Systolic BP 120 – 139 / Diastolic BP 80 – 89 mmHg 

 Stage 1 Hypertension – Systolic BP 140 – 159 / Diastolic BP 90 – 99 mmHg 

 Stage 2 Hypertension – Systolic BP > 160 / Diastolic BP > 100 mmHg 

 Hypertensive Crisis – Systolic BP > 210 / Diastolic BP > 120 mmHg 

Complications of uncontrolled hypertension affect almost all the major organs of the body, especially when it graduates to hypertensive crisis. 

 Head and Neck 

 - Rupture of cerebral blood vessels (cerebrovascular accidents) usually involving berry aneurysms at the base of the brain 

 - Stroke from bleeding or ischemia (insufficient blood supply) 

 - Aortic Dissection – separation of the innermost and middle layers of the aorta by the influx of blood under high   

pressure, through a tear or ulceration of the endothelial plaque 

 - Papilledema – swelling of the optic disk in the eyes due to raised intracranial pressure, with the potential to cause sudden blindness 

Heart 

 - Heart Attack (Acute Coronary Syndrome) due to the narrowing of the coronary arteries supplying blood to the heart as a consequence of aortic dissection 

 - Congestive Heart Failure (CHF) occurs as the heart becomes unable to pump blood adequately against the very high pressure build up 

 Kidneys 

 - Kidney failure occurs especially with the dissection of abdominal aorta in the area of the exit of the renal artery 

 - Mild leakage of protein (proteinuria) and blood (hematuria) into the urine occurs with mild narrowing of the renal arteries 

 - Acute renal failure occurs with moderate narrowing of the renal arteries 

 - Renal crisis occurs with complete occlusion of the renal arteries 

 - Encephalopathy (brain toxicity) occurs from the accumulation of ammonia and its intermediate products in the blood circulating in the brain 

 Skin and Blood 

 Skin damage (scleroderma) and 

 – Acute anemia due to red blood cell damage with thin the blood vessels (microangiopathic hemolysis) also occurs during hypertensive crisis 

These complications all call for urgent or emergency care at the ER. Regular BP monitoring at home and during provider visits helps to prevent hypertension from reaching the crisis point. ER doctors have effective drugs like nitroprusside; nitroglycerine, labetalol, hydrallazine and phentolamine that combine very well to quickly knock down BP below the crisis point. Take the regular BP medications as instructed is very important to keep it under to control after it has been stabilized.