Difference between hypertensive encephalopathy and malignant hypertension

Written by Li Qiang
Intensive Care Unit
Updated on March 26, 2025
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The difference between hypertensive encephalopathy and malignant hypertension can be discerned from their names, indicating they are different conditions. Hypertensive encephalopathy refers to a condition where blood pressure rises sharply in a short period, with diastolic pressure exceeding 120 mmHg and systolic pressure exceeding 200 mmHg. This dramatic increase in blood pressure causes cerebral vasospasm and increased cerebral perfusion pressure, leading to various manifestations of cerebral edema, primarily severe headache, nausea, vomiting, seizures, and even brain herniation. The emphasis is on the rapid rise in blood pressure over a short term and its impact on the brain, specifically cerebral edema. Malignant hypertension also involves a rapid increase in blood pressure to extremely high levels over a short period. However, the focus of malignant hypertension is on the impact on multiple organs throughout the body, including the brain, but also severely affecting the heart, potentially causing acute left heart failure and pulmonary edema. In the kidneys, it can lead to acute renal failure, characterized by reduced urine output or anuria. Thus, malignant hypertension emphasizes the effects on multiple vital organs, whereas hypertensive encephalopathy focuses primarily on the impact on the brain and central nervous system. Hence, there are some distinctions between the two conditions.

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Which is more dangerous, low blood pressure or high blood pressure?

Blood pressure is a crucial indicator for maintaining human life. Both low blood pressure and high blood pressure can pose significant risks to the body. High blood pressure can lead to arteriosclerosis, and prolonged high blood pressure can cause cardiovascular and cerebrovascular diseases, with severe cases leading to cerebral ischemia and myocardial infarction. Low blood pressure affects the blood supply to vital organs and also brings negative factors to the body. Extremely low blood pressure can also endanger human life. Therefore, whether it is low blood pressure or high blood pressure, it should be correctly treated and improved under the guidance of a doctor to ensure the health of the body.

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How to prevent high blood pressure

The main methods to prevent hypertension are as follows: 1. Maintain a balanced diet, avoid long-term excessive intake of sodium salt, and make sure to consume plenty of fresh vegetables and fruits to supplement adequate amounts of potassium salt and dietary fiber; 2. Regularly participate in sports and physical labor, maintain an active lifestyle, avoid a sedentary lifestyle, and prevent significant weight gain; 3. Combine work with rest to avoid repeated fatigue and staying up late; work should be flexible, and ensure sufficient sleep at night; 4. Maintain a good mood, avoid frequent emotional fluctuations, and also avoid long-term mental overstrain; 5. Do not smoke and avoid excessive drinking.

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Causes of pregnancy-induced hypertension

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The difference between hypertensive nephropathy and renal hypertension

Hypertensive nephropathy and hypertension due to kidney disease need to be differentiated, as this affects the treatment approach and prognosis assessment differently. Hypertensive nephropathy refers to patients with long-term high blood pressure, which causes arteriosclerosis of small vessels leading to renal pathology. Often, there is also arteriosclerosis in other organs, such as the retinal arteries, which can be confirmed through funduscopic examination. On the other hand, hypertension due to kidney disease occurs when a patient has kidney disease first followed by hypertension, where the causes and types of kidney diseases vary and can frequently lead to hypertension. The difference between the two lies in the sequence of occurrence. Hypertensive nephropathy is characterized by initial high blood pressure and commonly associated with arteriosclerosis in other vessels, which can be preliminarily identified through funduscopic examination. In cases of hypertension due to kidney disease, the patient has other kidney disorders first, followed by hypertension. If a patient's 24-hour urine protein quantification exceeds 2g, it is likely due to kidney disease rather than hypertensive nephropathy. If differentiation remains challenging, kidney biopsy can be performed for further differentiation.

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How to treat high blood pressure?

Hypertension is a common and frequently occurring disease in clinical practice. Hypertension can cause certain damage to the body, especially long-term hypertension which can lead to cardiovascular and cerebrovascular diseases. It is necessary to adjust the dietary structure, paying attention to a low-fat and low-salt diet. Meanwhile, according to the severity of the blood pressure, effective antihypertensive drugs should be used under the guidance of a doctor to adjust the blood pressure within the normal range, avoiding serious damage to the cardiovascular and cerebrovascular systems, and also engaging in aerobic exercise. Mild hypertension patients can lower their blood pressure to the normal range through dietary adjustments and aerobic exercises.