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[Malignant arterial hypertension, symptomatic and prognostic aspects. Retrospective study of 140 cases]
Insights
Survival rates for malignant hypertension have doubled due to advances in research and treatment. Early diagnosis and intervention significantly improve outcomes for patients with this severe form of high blood pressure.
Area of Science:
- Nephrology
- Cardiology
- Ophthalmology
Context:
- Malignant hypertension presents with severe hypertension (183 +/- 17 mm Hg) and Grade III-IV retinopathy.
- Significant renal failure (84%) and left heart failure (43%) were common comorbidities.
- Associated renal diseases (48%), essential hypertension (41%), and renovascular lesions (9%) were identified.
Purpose:
- To analyze the clinical characteristics and outcomes of 140 malignant hypertension cases.
- To evaluate changes in survival rates over a 17-year period.
- To identify factors contributing to improved patient survival.
Summary:
- Malignant hypertension patients exhibited high blood pressure, severe retinopathy, and frequent renal and cardiac complications.
- Neurological damage was present in 27% of patients.
- 5-year survival rates increased from 35% (1966-1970) to 72% (1977-1982).
Impact:
- Therapeutic advancements and increased research have doubled 5-year survival rates for malignant hypertension.
- Improved management strategies have significantly enhanced prognosis for hypertensive patients.
- This study highlights the critical role of ongoing medical progress in managing severe hypertension.
Abstract:
140 cases of malignant hypertension were diagnosed in our clinic from January 1966 to December 1982. On admission the mean blood pressure was 183 +/- 17 mm Hg, and all patients had grade III to IV retinopathy according to the Keith and Wagener classification; 84% of the patients had renal failure (10% of acute origin). 43% of the patients presented with clinical signs of left heart failure. Hypertension was associated with various renal diseases in 48%, was essential in 41%, and renovascular lesions were found in 9% of the cases. Headaches, asthenia and visual disorders were the 3 main symptoms of malignant hypertension, as classically described. Severe cerebral damage (including all the neurological manifestations present on admission) was found in 27% of the patients. Among the 122 patients available to follow-up, half died during the study period. The survival rate, calculated on a 5-year basis, has doubled compared with a similar patient population 17 years ago, increasing from 35% (period 1966 to 1970) to 72% (period 1977-1982). This remarkable achievement in survival rate is due to more intensive research and therapeutic progress (including, more recently, extrarenal epuration) reaching an increasingly large hypertensive population.