Which set of findings defines malignant hypertension in this material?

• A. Systolic greater than 180, diastolic greater than 110, symptoms
• B. Systolic greater than 220, diastolic greater than 129, symptoms of end organ damage
• C. Systolic greater than 240, diastolic greater than 120, symptoms of end organ damage
• D. Systolic greater than 200, diastolic greater than 100, symptoms of end organ damage

Answer: (B)

Malignant hypertension is a hypertensive emergency marked by extremely high blood pressure with acute end-organ damage. In this material, it is defined by a systolic pressure exceeding 220 mmHg and a diastolic pressure exceeding 129 mmHg, accompanied by symptoms of end-organ damage. This combination signals rapid vascular injury and the need for urgent management.

The other sets don’t fit this material’s definition because they either use lower blood pressure thresholds or omit the requirement for end-organ damage. For example, pressures around 180/110 or 200/100 may indicate severe hypertension or a crisis but not the malignant pattern specified here, which hinges on both the very high numbers and the presence of end-organ symptoms.