Detailed Explanation of the Differences Between Gradual and Rapid Hypertension and the Risk of Complications

Slow-onset hypertension, also known as benign hypertension, typically develops after middle age.

Malignant hypertension, also known as malignant hypertension, accounts for 1% of hypertension cases. It can develop suddenly from slow-onset hypertension or be malignant from the onset. Its pathological characteristics include changes in small arteries throughout the body, especially in the kidneys, primarily fibrinous necrosis with significant intimal thickening, leading to proliferative endocarditis. Malignant hypertension can occur at any age, but is most common between 30 and 40 years old. Symptoms include significantly elevated blood pressure, with diastolic pressure often exceeding 130 mmHg, fatigue, thirst, polyuria, rapid vision loss, retinal hemorrhage and exudates, proteinuria, hematuria, and renal insufficiency. Heart failure, hypertensive encephalopathy, and hypertensive crisis may also occur. The disease progresses rapidly, often leading to death from uremia.

Diagnostic criteria for hypertension: A blood pressure conference was held in Japan. At this conference, new guidelines for hypertension treatment were established, new diagnostic criteria for hypertension were clarified, and comprehensive prevention and treatment strategies for hypertension were proposed. The definition of hypertension is: a systolic blood pressure greater than or equal to 140 mmHg and a diastolic blood pressure greater than or equal to 90 mmHg without the use of antihypertensive medication. Even if a patient has a history of hypertension and is currently using antihypertensive medication, and their current blood pressure does not reach the above levels, they should still be diagnosed with hypertension.

Cerebrovascular accident: Cerebrovascular accident, also known as stroke, is a sudden and severe condition with a very high mortality rate and a high risk of disability. It is the most serious type of acute cerebrovascular disease. The higher the blood pressure in a hypertensive patient, the higher the incidence of stroke. Hypertensive patients all have arteriosclerosis. When cerebral arteriosclerosis reaches a certain level, coupled with momentary excitement or excessive agitation, such as anger, a sudden accident, or strenuous exercise, blood pressure rises sharply, causing cerebral blood vessels to rupture and bleed. Blood spills into the surrounding brain tissue, at which point the patient immediately loses consciousness and falls to the ground; hence, it is commonly known as a stroke. If a hypertensive patient experiences dizziness, headache, nausea, numbness, or weakness after excessive exertion, anger, or emotional excitement, stroke should be highly suspected, and the patient should be taken to the hospital immediately for examination.

The possibility of hypertension complicated by kidney failure is approximately 10%. Hypertension and the kidneys have a close and complex relationship. On the one hand, hypertension causes kidney damage; on the other hand, kidney damage worsens hypertension. Hypertension and kidney damage can influence each other, creating a vicious cycle. Rapidly developing hypertension can cause widespread glomerular arterial disease, leading to malignant renal arteriosclerosis and rapidly progressing to uremia.