Abstract:
OBJECTIVE:To investigate the factors affecting survival in patients with malignant hypertension by analysing the prognosis of all of the patients referred to the City Hospital, Birmingham, with malignant hypertension since 1965. RESULTS:We identified 315 patients with malignant hypertension (211 men, 104 women; mean age +/- SD 49.4 +/- 12.7 years). Of those patients, 219 were Caucasian, 55 were black and 41 were Asian. Black patients had greater renal impairment and higher blood pressures at presentation. After a median follow-up period of 33 months (range 1-389), 126 patients (40.0%) were still alive, 126 patients (40.0%) were dead, 10 patients (3.2%) were receiving chronic haemodialysis and 53 patients (16.8%) were lost to follow-up. Mean follow-up blood pressures in the patients who died were significantly higher than in those who lived. Median survival times for Caucasian, black and Asian patients were 121.0, 30.4 and 107.5 months, respectively, with the lowest survival time being that of black patients. There was a lower median survival time among patients with proteinuria and high serum urea (> 10 mmol/l) and creatinine (> 200 mumol/l) levels at presentation and if left ventricular hypertrophy was detected on the electrocardiogram, but there was no difference in median survival time between those with and without haematuria, nor between non-smokers and current or former smokers. The most common causes of death were renal failure (39.7%), stroke (23.8%), myocardial infarction (11.1%) and heart failure (10.3%). Median survival times for the patients who presented before 1970, during 1970-1979 and during 1980-1989 were 39.2, 68.6 and 144.0+ months, respectively, demonstrating an improved survival time for the patients who were diagnosed after 1980. Using multivariate Cox's proportional hazards analyses, the duration of known hypertension and serum urea level at presentation were found to be the main predictors of survival. CONCLUSION:Malignant hypertension remains a disease with a poor overall prognosis, namely progression to death or chronic renal haemodialysis. The prognosis has improved with recent advances in therapy, with a 5-year survival of 74% of patients. The poor outlook for black patients could be explained by their late presentation with severe hypertension and the higher prevalence of renal impairment in this group.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Lip GY,Beevers M,Beevers DGdoi
10.1097/00004872-199508000-00013subject
Has Abstractpub_date
1995-08-01 00:00:00pages
915-24issue
8eissn
0263-6352issn
1473-5598journal_volume
13pub_type
杂志文章abstract:INTRODUCTION:Recent randomized controlled trials have confirmed the ability of renal denervation to lower blood pressure (BP) in patients, resistant to the BP-lowering effect of multiple antihypertensive drug administration. Evidence is limited, however, in patients with end-stage renal disease (ESRD) and haemodialysis...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002358
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:The interaction between trophoblasts and maternal endothelium is important for placental vascular modeling. Failure of uterine spiral artery transformation is linked to the etiopathology of preeclampsia. Antihypertensive medications used to control hypertension in early pregnancy can alter placental and circ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000134
更新日期:2014-05-01 00:00:00
abstract::We have previously reported that pressor doses of angiotensin II induce atrial natriuretic factor (ANF) release. Since the number of glomerular and vascular ANF receptors may vary inversely with plasma ANF levels, we investigated whether they are modified by angiotensin II. Male rats were infused intraperitoneally for...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Although 24-h urinary measure to estimate sodium and potassium excretion is the gold standard, it is not practical for large studies. We compared estimates of 24-h sodium and potassium excretion from a single morning fasting urine (MFU) using three different formulae in healthy individuals. M...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000122
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Enhanced mechanical forces, e.g. in arterial hypertension, stimulate the formation of reactive oxygen species (ROS) by the NAD(P)H oxidase. Since bone marrow derived endothelial progenitor cells (EPCs) contribute to vascular remodeling and repair, we investigated whether renovascular hypertension stimulates ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282f09f79
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:In order to optimize cardiovascular risk assessment, we compared the association of common carotid artery intima-media thickness (CCA-IMT) with carotid and/or iliofemoral (C/IF) plaques according to the presence or absence of cardiovascular disease (CVD) and belonging to a high cardiovascular risk group. DES...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000052494.18130.80
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that vascular beta 2-adrenoceptor hyporesponsiveness in spontaneously hypertensive rats (SHR) is not induced by increased blood pressure or venous hypertrophy. DESIGN:We compared the attenuating effects or isoprenaline, sodium nitroprusside and verapamilon the portal veins from Wistar-...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199509000-00013
更新日期:1995-09-01 00:00:00
abstract::Blood pressure, plethysmographically determined muscle blood flow in the calf at rest and during maximal dilatation, plasma renin activity, angiotensin II and plasma and urinary aldosterone were determined in normotensive men with a positive family history of hypertension (n = 17) and in an age- and weight-matched con...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:Poor adherence to treatment is one of the major problems in the treatment of hypertension. Self blood pressure measurement may help patients to improve their adherence to treatment. METHOD:In this prospective, randomized, controlled study coordinated by a university hospital, a total of 228 mild-to-moderate...
journal_title:Journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1097/HJH.0b013e328334f36b
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVES:Urotensin II is the most potent vasoconstrictor known. Its role in hypertension has not been investigated. Here, we studied the plasma levels in hypertensive and normotensive human subjects. DESIGN:A cross-sectional case-control study. SETTING:Hypertension clinic and research clinic of a university teachin...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000125452.28861.f1
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVES:To assess the impact of various criteria used to define hypertension in community surveys on estimates of prevalence, treatment and control. In particular, this paper examines the effect of using mean versus minimum values; one, two or three examinations; and three different blood pressure levels. DESIGN:A ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715030-00004
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Cardiac angiotensin AT1 receptors have been found in several animal species. In-vitro studies performed on cardiac preparations have shown that angiotensin II (ANG II) exerts a positive inotropic effect; however, in-vivo results have allowed no definitive conclusion to be drawn. The reasons behind these cont...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715090-00013
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVES:To determine whether 'slow pressor' hypertension from systemic angiotensin (Ang II) infusion was associated with renal vascular structural remodeling of the renal resistance vessels and glomerulus. METHODS:Ang II (4.5-10 ng/kg per min) or vehicle was infused for 10 days. Renal resistance vascular lumen chan...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200307000-00031
更新日期:2003-07-01 00:00:00
abstract::Fish and fish oils have been reported to reduce blood pressure in normotensives and untreated hypertensives. The present study examined the effect of dietary supplementation with fish oil on blood pressure in 20 treated hypertensives with controlled blood pressures who continued their usual antihypertensive drug treat...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-199004000-00007
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVES:To assess the expression of early cardiac genes, implicated in the hypertrophic growth response of the adult heart, in peripheral blood mononuclear cells in patients with essential hypertension and its relationship to ambulatory blood pressure monitoring (ABPM) parameters and to echocardiographic left ventri...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283424bc4
更新日期:2011-04-01 00:00:00
abstract::Several myosin isoforms are expressed in smooth muscle, based upon both heavy and light chain polymorphisms. These myosin isoenzymes reveal distinct detachment rate constants, thus regulating the responsiveness of the VSMC contractile apparatus to Ca2+, as well as its energetical and mechanical behavior. ...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/00004872-199205000-00002
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:To estimate the sensitivity and specificity of self-reported hypertension (HTN) as compared with the clinical diagnosis in epidemiological studies. METHODS:We searched MEDLINE, Embase, Scopus, Web of Science, LILACS, Google Scholar, and ProQuest Dissertations & Theses Global: Health & Medicine databases. In ...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析
doi:10.1097/HJH.0000000000001648
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:The difference between clinic and ambulatory blood pressure (BP) is a poor estimate of the true white-coat effect (WCE) measured with beat-to-beat recording. METHOD:We investigated whether the difference between clinic and home BP (home WCE) was a better estimate of true WCE than ambulatory WCE. In 73 young...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283589ee6
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the mean levels of blood pressure and hypertension (> or = 140 mmHg systolic or > or = 90 mmHg diastolic pressure or on treatment for hypertension) in the adult English population, and to evaluate any changes in the efficacy of hypertension management between 1994 and 2003. DESIGN/METHODS:Cross-s...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000226210.95936.bc
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:Few data are available comparing the effects of monotherapy and combination therapy on target organ damage. The PICXEL study compared the efficacy of a strategy based on first-line combination with perindopril/indapamide versus monotherapy with enalapril in reducing left ventricular hypertrophy (LVH) in hyper...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.hjh.0000187253.35245.dc
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:Blood pressure (BP) variability (BPV) may offer independent prognostic information. However, data supporting this notion are inconsistent, and this may be due to the wide variety of methodologies used for measuring BPV. A systematic analysis on the effect of BPV methodologies on BPV itself has never been und...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0000000000001606
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:The platelet GPIIIa plays a pivotal role in platelet aggregation. Previous studies showed an association between the GPIIIa Pl(A1/A2) polymorphism and coronary thrombosis, while there is only contrasting evidence about its role in stroke. We explored the possibility that this polymorphism represents a risk fa...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328013cd67
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Genetic variability in the gene for aldosterone synthase--a key enzyme in the production of aldosterone--can affect sodium homeostasis and thereby blood pressure. The possibility of impaired aldosterone production for the development of hypertension is of particular relevance in black Afro-Caribbeans exposed...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200301000-00018
更新日期:2003-01-01 00:00:00
abstract::Behavioral stress and high dietary salt have been reported to increase blood pressure additively in non-human primates. This study was designed to replicate this phenomenon and to assess neuroendocrine correlates and responses to two commonly used antihypertensives, a beta-adrenoceptor blocker and a thiazide diuretic....
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Small size at birth and greater BMI in childhood are associated with greater brachial blood pressure (BP) in later life. Aortic (central) BP differs from brachial BP and is more predictive of organ damage and cardiovascular events; the relationship between BMI in childhood and central BP is not known. METHO...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000269
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of angiotensins acting at the rostral ventrolateral medulla (RVLM) on the cardiovascular adjustments following haemorrhage. DESIGN:Changes in mean arterial pressure (MAP) and heart rate (HR) produced by micro-injections of angiotensin II (Ang II) and angiotensin (Ang)-(1-7) and differ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199917080-00014
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Activated coagulation Factor XII (FXIIa) infusion increases peripheral resistance (TPR) and mean arterial pressure (MAP) of Brown Norway but not plasma kininogen deficient Brown Norway Katholiek (BNK) rats. FXIIa concentrations are elevated in hypertensive end-stage renal disease patients receiving conventio...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000192
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:In this randomized, double-blind, crossover study, the antihypertensive efficacy of amlodipine and nifedipine gastrointestinal therapeutic system (GITS) was compared following missed doses. Design and methods In a randomized crossover design, 42 patients were randomized to receive amlodipine (5-10 mg) or the ...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-200202000-00025
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:In clonal animal cells, certain angiotensin receptor blockers (ARB) activate the peroxisome proliferator-activated receptor-gamma (PPARgamma). The aim of this work was to validate that observation in human cells and humans. METHODS:We investigated the induction of in-vitro adipogenesis and the activation of ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000242405.68461.84
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:This study evaluated the impact of prolonged circulatory unloading and subsequent left ventricular (LV) mass decrease on LV myocardial performance. Five-week head-down tilt (-6°) bed rest (HDTBR) was used as a model of prolonged circulatory unloading. METHODS:Ten young healthy male volunteers (age 23 ± 2 yea...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32833f5e01
更新日期:2011-01-01 00:00:00