Hypertension is a chronic disease, and even if complications occur, it usually takes 10 to 20 years to resolve. However, some cases of hypertension can become life-threatening, causing kidney failure, heart failure, retinal hemorrhage, and coma within 2 to 3 years, and are called malignant hypertension. According to the diagnostic criteria created by a research team at the Ministry of Health, Labor and Welfare, the characteristics of malignant hypertension are: 1) a minimum blood pressure of 130 mmHg or higher, 2) fundus examination reveals significant bleeding or arteriosclerosis or congestion in the optic disc, 3) rapid progression of renal dysfunction indicating renal failure, and 4) it is often accompanied by symptoms of increased intracranial pressure such as headache, vomiting, and coma, as well as heart failure. Treatment involves lowering blood pressure with multiple powerful vasodilators. After that, treatment will be based on the severity of the nephrosclerosis ("nephrosclerosis"). Source: Shogakukan Home Medical Library Information |
高血圧は慢性の経過をたどる病気で、合併症をおこすにしても、10年、20年といいう月日がかかるのがふつうです。ところが、高血圧のなかには、2~3年のうちに腎不全(じんふぜん)、心不全(しんふぜん)、眼底出血、昏睡(こんすい)などをおこして生命にかかわるものがあって、悪性高血圧といいます。 厚労省の研究班が作成した診断基準では、①最低血圧が130mmHg以上ある、②眼底検査(がんていけんさ)で、著しい出血や動脈硬化(どうみゃくこうか)がみられ、乳頭(にゅうとう)にうっ血(けつ)がみられる、③腎機能障害(じんきのうしょうがい)が急速に進み、腎不全を示す、④頭痛、嘔吐(おうと)、昏睡などの脳圧亢進症状(のうあつこうしんしょうじょう)や心不全をともなうことが多い、などが悪性高血圧の特徴です。 治療は、複数の強力な血管拡張薬を使用して血圧を下げます。 その後は、腎硬化症(じんこうかしょう)(「腎硬化症」)の程度に準じて治療します。 出典 小学館家庭医学館について 情報 |
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