Key result
Labetalol and nicardipine lead guideline recommendations as first-line therapies for prompt treatment of malignant hypertension.
Why the study?
Malignant hypertension is characterized by extreme blood pressure elevation and acute target organ microvascular damage, requiring an examination of its pathogenesis, predisposing variables, therapy, and preventive strategies.
This review summarizes current guidelines and strategies for managing malignant hypertension, emphasizing prompt treatment with labetalol or nicardipine as first-line therapies.
Endorses guideline-directed first-line agents; leaves open need for prospective trials on targets and outcomes.
Introduction: Based on office blood pressure (BP) values, hypertension is categorized into three stages: stage 1 (140-159/90-99 mmHg), stage 2 (160-179/100-109 mmHg), and stage 3 (≥180/≥110 mmHg). Malignant hypertension (MHT) is characterized by extreme BP elevation (systolic blood pressure above 200 mmHg and diastolic blood pressure above 130 mmHg) and acute microvascular damage affecting various organs, particularly the retinas, brain, and kidneys. Objectives: The pathogenesis, predisposing variables, therapy, and preventive strategies for MHT were examined in this review. Conclusions and recommendations: Malignant hypertension requires prompt and efficient treatment because it is the most severe kind of hypertension that affects target organs. At the same time, there are a number of alternatives available for treating MHT. The International Society of Hypertension 2020 and European Society of Cardiology/European Society of Hypertension 2018 recommendations suggest using labetalol and nicardipine as the first-line choice, with urapidil and nitroprusside serving as alternative medications. Elevated risk of MHT has been linked to many socio-demographic and genetic factors.
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Tsige et al. (2024) conducted a review in Malignant hypertension. Labetalol and nicardipine was evaluated. Malignant hypertension requires prompt treatment, with labetalol and nicardipine recommended as first-line therapies by international guidelines.
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