Malignant Hypertension—Improving Prognosis in a Rare Disease

Abstract

A follow-up was made of 69 patients diagnosed as having malignant hypertension during 1969-76, essential in 26, secondary in 39 and unclassified in 4. A clear male dominance was seen (41 men, 28 women), particularly in the group with essential hypertension (18 men, 8 women). The mortality in this series was less than in previously published series. The 5 yr survival rate was 75% in the patients with essential and 72% in those with secondary hypertension. This was partly due to hemodialysis and renal transplantation. The importance of renal function at the time of diagnosis was evident in this study. In most patients with essential hypertension and serum creatinine levels below 300 .mu.mol/l, renal function could be maintained or improved when antihypertensive treatment was instituted, whereas progression of the renal damage was seen in those with serum creatinine levels above 300 .mu.mol/l in spite of antihypertensive treatment with 3 or more drugs. The incidence of new cases of malignant hypertension tended to decrease during the observation period, particularly regarding essential hypertension.