Difference between hypertensive crisis and hypertensive encephalopathy

Written by Zhou Yan
Geriatrics
Updated on September 22, 2024
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Hypertensive crisis, now referred to as hypertensive emergency, includes hypertensive encephalopathy. It mainly refers to cases where, under certain triggers, the blood pressure of patients with primary or secondary hypertension suddenly or significantly rises, typically exceeding 180/120 mmHg, accompanied by progressive failure of critical target organs such as the heart, brain, and kidneys. Hypertensive emergencies include hypertensive encephalopathy, cerebral hemorrhage, cerebral infarction, acute heart failure, acute coronary syndrome, aortic dissection, etc. Hypertensive encephalopathy is characterized by symptoms caused by hypertension, such as headache, blurred vision, nausea, vomiting, and severe edema of the head.

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Written by Li Qiang
Intensive Care Unit
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Difference between hypertensive encephalopathy and malignant hypertension

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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Written by Zhang Yue Mei
Cardiology
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What to eat for high blood pressure

Patients with hypertension need to regularly take antihypertensive medication to bring their blood pressure within the normal range. In daily life, dietary adjustments should be made, avoiding foods high in fats such as fatty meat from animals, offal, fried foods, and sweets. Instead, consume more vegetables high in dietary fiber, vitamins, and trace minerals. Suitable vegetables for people with hypertension include celery, spinach, mung bean sprouts, black fungus, water chestnuts, onions, carrots, winter melon, and Chinese cabbage.

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Written by Di Zhi Yong
Cardiology
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How to monitor blood pressure in hypertensive crisis

If a patient experiences a hypertensive crisis, it is recommended that they use an electrocardiogram monitor. This can effectively monitor changes in the patient's heart rate, blood pressure, and pulse. If there is a rise in blood pressure, it can be immediately observed. The occurrence of a hypertensive crisis is very dangerous and can lead to complications, potentially causing damage to liver and kidney functions, and leading to cardiovascular and cerebrovascular events. In particular, it is prone to causing cerebral hemorrhage or coronary heart disease. In such cases, it is crucial to actively use antihypertensive drugs to control symptoms. Regarding diet, it is important to maintain a light diet, especially limiting sodium intake, in order to control the phenomenon of high blood pressure in patients.

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Written by Li Hai Wen
Cardiology
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Normal blood pressure, high blood pressure, and low blood pressure ranges.

Normal adult systolic blood pressure is between 90-139mmHg, and diastolic pressure is between 60-89mmHg. When the systolic pressure exceeds 140mmHg and the diastolic pressure exceeds 90mmHg, this condition is medically referred to as hypertension. When the systolic pressure is below 90mmHg and the diastolic pressure is below 60mmHg, this condition is medically referred to as hypotension. Regardless of whether it is hypertension or hypotension, it often causes symptoms in patients, such as headache, dizziness, and fatigue. Therefore, whether it is hypertension or hypotension, one should visit the hospital's department of cardiology for a formal examination. The doctor will assess the situation on-site to determine if treatment is necessary and how to administer it.

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Written by Zhang Lu
Obstetrics
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Symptoms of Hypertension in Pregnant Women

During pregnancy, if a pregnant woman develops high blood pressure, initially there are no symptoms, because at the beginning the blood pressure just slightly exceeds 140/90mmHg. If the high blood pressure is only temporary, it generally does not affect the woman's body and therefore, she may not experience any symptoms. As the condition progresses, the symptoms of high blood pressure can cause physical harm to the woman, likely damaging the kidneys and causing proteinuria. The loss of protein can lead to edema in women, and as a result, many women's initial symptoms will appear as generalized swelling, which does not improve with rest. By measuring blood pressure and urinary protein, symptoms of hypertension in pregnant women can be detected. In the later stages of the disease, hypertension may sometimes be accompanied by dizziness, indigestion, and mild pain in the lower abdomen, which are all symptoms of hypertension in pregnant women.