Malignant hypertension in north west India. A hospital based study.
One hundred and thirty-five patients with malignant hypertension seen over a period of 11 years (1979 to 1989) at a referral hospital were analyzed to characterize the clinical features and etiology of this disease. Ninety male and 45 female patients with an average age of 38.2 +/- 1.4 years were studied. Malignant hypertension was the presenting feature in 68 patients. The etiology included essential hypertension in 88 patients and a secondary cause in 47 patients. Secondary causes included a renovascular etiology in 20 patients, renal parenchymal disease in 19, pheochromocytoma in 6 and Conn's syndrome and adrenal carcinoma in one patient each. Among the 20 patients with renovascular hypertension, Takayasu's arteritis was seen in 15 (75%). The mean age of patients with essential hypertension was 41.7 + 1.14 years while the mean age in patients with secondary hypertension was 33.2 + 1.96 years. Duration of preexisting hypertension was longer in essential hypertensives (2.42 + 0.45 years) than in patients with secondary hypertension (1.27 + 0.41 years, p < 0.05). Raised serum creatinine was seen in 93 patients. Seventy-seven patients had left ventricular hypertrophy on ECG. Ninety-six patients were followed for a period ranging from 18 months to 10 years (mean 32 months). Sixteen patients died during hospital stay while 6 patients died during the follow-up period. The deaths were related to the effects of uncontrolled hypertension including, renal failure (11), stroke (6), congestive cardiac failure (3) and myocardial infarction (1).(ABSTRACT TRUNCATED AT 250 WORDS)
Sharma
B K
BK
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Singh
G
G
Sagar
S
S
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000150:complications; D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000150:complications; D005260:Female; D006801:Humans; D006974:Hypertension, Malignant / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D006978:Hypertension, Renovascular / Q000453:epidemiology / Q000209:etiology; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D007194:India / Q000453:epidemiology; D007674:Kidney Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications; D011379:Prognosis; D013625:Takayasu Arteritis / Q000150:complications