Hypertension, malignant: Difference between revisions

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== Additional Info ==

*Malignant hypertension is extremely high blood pressure that develops rapidly and ~~causes~~ some type of organ damage. "~~Normal~~" ~~blood pressure~~ is ~~below 140/90. A person~~ with ~~malignant hypertension has a blood pressure~~ that's ~~typically above 180/120~~. Malignant hypertension should be treated as a medical emergency.

*Malignant hypertension is extremely high blood pressure that ''usually'' develops rapidly and to qualify MUST be associated with some type of acute organ damage from the high BP

**The acute organ damage can be of any degree (and includes hypertensive encephalopathy which can be fully reversible once the BP comes down) and any organ -- but must be due to the high BP itself.

*~~Malignant Hypertension only coded~~ if ~~it is an emergency~~ and organ damage ~~is evident~~.

*What is considered "extremely high" is, in textbooks SBP>180 or DBP>110, but are certainly people with BP this high that is "chronic" that don't have the organ damage that's required for this code. Malignant hypertension should be treated as a medical emergency.

**'''BUT if somebody has a BP say 178/108 that's acute and has the organ damage, it should STILL be called malignant hypertension despite not meeting that arbitrary numerical threshold.'''

~~{{Discuss | who = Allan | question =~~

*Due to all of this, the need for an acutely higher than normal BP AND end-organ damage due to it --- there may be an aspect of this diagnosis that has some subjectivity to it, i.e. "Is the BP high enough?" or "Is the organ dysfunction seen due to that acutely high BP?"

* ~~I would like~~ to ~~submit~~ the ~~following definition~~ for ~~peer review and discussion for Malignant Hypertension. Malignant Hypertension is extremely high blood pressure that develops rapidly and causes some type of~~ organ damage~~. "Normal" blood pressure is <140/90. A person with Malignant Hypertension has a BP typically >180/120~~ --~~mvpenner 11:02~~, ~~2015 April 15~~

* Hypertensive urgency

** had a brief look at https://en.~~wikipedia~~.~~org/wiki/Hypertensive_emergency and it looks like additional things need~~ to ~~be present to define as hypertension. would you be OK if we just linked to there as we do fro many articles~~? ~~Ttenbergen 15:27, 2015 April 15~~

* Hypertensive emergency

*** Thank you!--mvpenner 06:04, 2015 April 16

* Hypertensive crisis

**** Does that mean you agree that adding a link would be a solution/improvement? Ttenbergen 17:39, 2015 April 16

***** Thank Tina. I agree with posting the link, but also see benifit in having a brief summary in the definitions.--mvpenner 07:56, 2015 April 20 (CDT)

****** Sure, but it needs to include all the relevant parts. From reading the wikipedia entry I didn't think the one you proposed would. Could someone more medical weigh in? I am just looking at it from a consistency angle... Ttenbergen 13:55, 2015 April 20}}

== Alternate ICD10s to consider coding instead or in addition ==

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 == Additional Info ==
-*Malignant hypertension is extremely high blood pressure that develops rapidly and causes some type of organ damage. "Normal" blood pressure is below 140/90. A person with malignant hypertension has a blood pressure that's typically above 180/120. Malignant hypertension should be treated as a medical emergency.
+*Malignant hypertension is extremely high blood pressure that ''usually'' develops rapidly and to qualify MUST be associated with some type of acute organ damage from the high BP
+**The acute organ damage can be of any degree (and includes hypertensive encephalopathy which can be fully reversible once the BP comes down) and any organ -- but must be due to the high BP itself.
-*Malignant Hypertension only coded if it is an emergency and organ damage is evident.
+*What is considered "extremely high" is, in textbooks SBP>180 or DBP>110, but are certainly people with BP this high that is "chronic" that don't have the organ damage that's required for this code. Malignant hypertension should be treated as a medical emergency.
+**'''BUT if somebody has a BP say 178/108 that's acute and has the organ damage, it should STILL be called malignant hypertension despite not meeting that arbitrary numerical threshold.'''
-{{Discuss | who = Allan | question =
+*Due to all of this, the need for an acutely higher than normal BP AND end-organ damage due to it --- there may be an aspect of this diagnosis that has some subjectivity to it, i.e. "Is the BP high enough?" or "Is the organ dysfunction seen due to that acutely high BP?"
-* I would like to submit the following definition for peer review and discussion for Malignant Hypertension. Malignant Hypertension is extremely high blood pressure that develops rapidly and causes some type of organ damage.  "Normal" blood pressure is <140/90.  A person with Malignant Hypertension has a BP typically >180/120 --mvpenner 11:02, 2015 April 15
+* Hypertensive urgency
-** had a brief look at https://en.wikipedia.org/wiki/Hypertensive_emergency and it looks like additional things need to be present to define as hypertension. would you be OK if we just linked to there as we do fro many articles? Ttenbergen 15:27, 2015 April 15
+* Hypertensive emergency
-*** Thank you!--mvpenner 06:04, 2015 April 16
+* Hypertensive crisis
-**** Does that mean you agree that adding a link would be a solution/improvement? Ttenbergen 17:39, 2015 April 16
-***** Thank Tina. I agree with posting the link, but also see benifit in having a brief summary in the definitions.--mvpenner 07:56, 2015 April 20 (CDT)
-****** Sure, but it needs to include all the relevant parts. From reading the wikipedia entry I didn't think the one you proposed would. Could someone more medical weigh in? I am just looking at it from a consistency angle... Ttenbergen 13:55, 2015 April 20}}
 == Alternate ICD10s to consider coding instead or in addition ==