Difference between hypertensive encephalopathy and malignant hypertension

Written by Li Qiang
Intensive Care Unit
Updated on March 26, 2025
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Li Liu Sheng
Nephrology
1min 1sec home-news-image

How is hypertensive nephropathy treated?

Long-term hypertension can lead to abnormal kidney structure and function, also known as hypertensive nephropathy. Once hypertensive nephropathy is diagnosed, comprehensive treatment measures are often adopted, including both pharmacological and non-pharmacological treatments. In terms of non-pharmacological treatment, patients should maintain a low-salt diet in their daily life, focusing on a light diet, with a daily salt intake of about 4 grams. Regarding pharmacological treatment, the main goal is to control the patient's blood pressure and reduce urinary protein. Medications that can be used include angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists. Any of these medications can be chosen and used long-term to control blood pressure, protect kidney function, and reduce urinary protein. (Medications should be used under the guidance of a physician, and self-medication should be avoided.)

doctor image
home-news-image
Written by Li Hai Wen
Cardiology
53sec home-news-image

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.

doctor image
home-news-image
Written by Zhang Yue Mei
Cardiology
54sec home-news-image

Causes of high blood pressure

Hypertension is clinically divided into primary hypertension and secondary hypertension. Primary hypertension is characterized by elevated blood pressure without other symptoms, and the current clinical diagnostic methods cannot determine the cause of the blood pressure rise, which is referred to as primary hypertension. Secondary hypertension occurs as a result of other diseases, with the most common being hyperthyroidism, glomerulonephritis, arteritis, atherosclerosis, and other diseases causing high blood pressure. After the onset of hypertension, effective antihypertensive drugs must be used for treatment. Hypertension is not to be feared, but the damage it causes to the body is. (Specific medications should be used under the guidance of a physician)

doctor image
home-news-image
Written by Zhang Yue Mei
Cardiology
56sec home-news-image

How to Read a Blood Pressure Monitor for High Blood Pressure

As living standards improve, a blood pressure monitor has become an essential medical device in households. Electronic blood pressure monitors are very convenient for measuring blood pressure, especially for patients with hypertension. They allow patients to measure their blood pressure timely and adjust medication dosages accordingly. How to read a blood pressure monitor varies with different models. Typically, on an electronic blood pressure monitor, the first line displays the systolic pressure, also known as high blood pressure; the second line displays the diastolic pressure, also known as low blood pressure; and the third line displays the heart rate. These readings can help you know your systolic and diastolic pressures.

doctor image
home-news-image
Written by Liu Ying
Cardiology
1min 4sec home-news-image

How to lower high blood pressure?

Hypertension is divided into primary hypertension and secondary hypertension. If it is secondary hypertension, removing the factors that cause high blood pressure can cure it. For example, if the hypertension is caused by an adrenal tumor, removing the tumor can normalize blood pressure. However, if diagnosed with primary hypertension, lifelong medication is required. There are many types of medications available, which need to be specifically analyzed based on the individual situation. If the patient primarily has high systolic pressure, it is recommended to use some calcium channel blockers, which are commonly used for elderly patients who primarily exhibit high systolic pressure. If it is primarily high diastolic pressure, some ACE inhibitors or ARBs are suggested. If sympathetic excitement is predominant, some β-blockers can be used. (Medication should be taken under the guidance of a professional doctor.)