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[Accelerated and malignant hypertension--clinical observation]
1Kliniki Nadciśnienia Tetniczego Instytutu Kardiologii, Warszawie.
Insights
Malignant hypertension, often secondary, presents with severe symptoms and complications. Prompt, aggressive treatment significantly improves blood pressure, renal function, and vascular lesions.
Area of Science:
- Cardiology
- Nephrology
- Hypertension Research
Context:
- Malignant hypertension is a severe form of elevated blood pressure.
- This study analyzed patients treated between 1981 and 1990.
- Secondary causes were identified in nearly 30% of malignant hypertension cases.
Purpose:
- To investigate the characteristics and outcomes of malignant hypertension.
- To compare malignant hypertension patients with those having milder forms.
- To evaluate the efficacy of prompt hypotensive treatment.
Summary:
- 101 cases of malignant hypertension were identified among 2195 patients.
- Malignant hypertensives showed shorter illness duration, lower education, higher smoking/alcohol use, and elevated blood pressure.
- Significant increases in urea, creatinine, and uric acid, along with mild anemia, were noted.
- 44% experienced severe cardiovascular complications like myocardial infarction and stroke.
- Effective hypotensive treatment led to significant blood pressure reduction, improved renal function, and reversal of fundoscopic changes.
Impact:
- Prompt and aggressive treatment normalizes blood pressure, reversing vascular damage.
- Treatment facilitates recovery of cerebral and renal functions.
- Highlights the importance of early intervention in managing severe hypertension.
Abstract:
There were 101 (4.6%) cases of malignant and accelerated hypertension among 2195 hypertensives patients treated in Department of Hypertension of National Institute of Cardiology between 1981 and 1990. Almost 30% of these patients were diagnosed as having secondary cause of hypertension. Comparison with control group of patients with moderate or mild hypertension revealed that malignant hypertensives had a shorter history of illness, lower level of education, higher evidence of smoking and over-consumption of alcohol. The systolic and diastolic blood pressure values were significantly higher in this group. The patients with malignant hypertension had significantly higher blood concentration of urea, creatinine and uric acid. Mild anemia was also present. Severe cardiovascular complications (myocardial infarction, stroke, encephalopathy, left ventricular failure) were observed in 44% cases of malignant hypertension. Due to efficacious hypotensive treatment blood pressure decreased significantly and biochemical indicators of renal function improved. Withdrawal of characteristic for malignant hypertension changes in fundoscopy was also observed. Results of this study indicate that prompt and aggressive treatment with normalization of blood pressure results in reversal of vascular lesions and permits recovery of cerebral and renal function.