Results of Treatment in Malignant Hypertension

Harington, M.; Kincaid‐Smith, Priscilla; McMichael, J.

doi:10.1136/bmj.2.5158.969

Cited by 167 publications

(43 citation statements)

References 19 publications

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“…We diagnosed these patients with accelerated-malignant hypertension by the three major symptom as follows : (1) severe hypertension (diastolic blood pressure > 130 mmHg), (2) retinal damage (the presence of linear or flame-shaped haemorrhages and cotton-wool spots) and (3) progressive renal failure (serum creatinine >2.0 and/or glomerular filtration rate <50 ml/min/1.73 m3). The diagnosis of any underlying causes has greater significance in malignant hypertension, therefore, patients with secondary causes of hypertension were excluded from this study by endocrinological and radiological examinations, including ultrasonography and computed tomography.…”

Section: Patients and Methods Subjectsmentioning

confidence: 99%

“…With the advent of effective drug therapy, the prognosis in hypertension, especially in accelerated-malignant hypertension, has improved substantially (1). Before the extensive usage of angiotensin-converting enzyme (ACE) inhibitors and calcium antagonists, ganglion blocking agents were the major therapeutic agents (2) . Malignant hypertension is predominantly an angiotensin-dependent form of hypertension (3).…”

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confidence: 99%

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Nifedipine and Arotinolol in Combination for Accelerated-Malignant Hypertension: Results of One Year Follow-Up.

et al. 1999

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The effects of a combined therapy with a calcium channel antagonist and a$-blocker in patients with accelerated-malignant hypertension on blood pressure and renal function were examined. Thirteen patients presented with the clinical features of malignant hypertension (diastolic blood pressure >130 mmHg, retinal damage and progressive renal failure) at our hospital, over the 3 yr period from 1995 to 1997. These patients were treated with both a calcium antagonist, 60-80 mg/d dose of long acting nifedipine, and an a/9-blocker, 20 mg/d dose of arotinolol, for over 12 mo. At admission, the average blood pressure of the patients was 233 ± 8/144 ± 3 mmHg. The level of serum creatinine in these patients was 6.2 ± 1.0 mg/dl. Intermittent hemodialysis therapy was introduced in 7 patients. Three days after treatment, blood pressure decreased to 162 ± 4/ 102 ± 4 mmHg. A month later, blood pressure decreased to 148 ± 3/89 ± 2 mmHg and serum creatinine levels were 3.6 ± 0.4 mg/dl. Renal function in these patients improved, and they completely recovered from renal dysfunction, allowing withdrawal of haemodialysis therapy. One year later, the blood pressure in all of these patients was well controlled and no further renal deterioration was observed, except in one patient. Despite the reduction in blood pressure, one patient was on hemodialysis three times a week after 8 mo of treatment. From these finding, it is concluded that combination therapy with a calcium antagonist and ai9-blocker is effective in both the reduction of highly elevated blood pressure and protection of the kidneys, resulting in amelioration of accelerated-malignant hypertension. (Hypertens Res 1999; 22: 75-'80)

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Section: Patients and Methods Subjectsmentioning

confidence: 99%

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confidence: 99%

Nifedipine and Arotinolol in Combination for Accelerated-Malignant Hypertension: Results of One Year Follow-Up.

et al. 1999

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“…That was initially apparent during treatment of malignant hypertension, when therapy improved a 5-year survival rate up to 30%. 3 It was later verified that the treatment of moderate or severe hypertension led to the reduction of cardiovascular disorders. 4 Subsequent studies, whether multicentred or not, confirmed the benefits of hypertension therapy, whereas due to the high number of participant patients they managed to show improvement even on the therapy of mild hypertension.…”

Section: Introductionmentioning

confidence: 99%

Significance of blood pressure levels achieved with felodipine anti-hypertensive treatment on cardiovascular structure and function changes

et al. 1998

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“…Almost four decades later, we have made huge hypertension, was published in 1959 by Harrington, Kincaid-Smith & McMichael [1] from the Hammerstrides(?) but the same debates still rage!…”

Section: Introductionmentioning

confidence: 99%

The treatment of hypertension

Chalmers

1996

Brit J Clinical Pharma

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1A ‘retrospective’ of the development of the drug treatment of hypertension is presented from the early days of ganglion blockers to the present time together with a review of the evidence of benefit from treatment. 2Current issues and debates are summarised including shortfalls in the control of hypertension in populations, difficulties surrounding the measurement of blood pressure, disagreement on the levels of blood pressure to treat, the goal blood pressures to aim at, issues surrounding lifestyle measures such as the low salt diet and low intensity exercise, and treatment with diuretics and with calcium antagonists. 3A ‘perspective’ is presented on some avenues for progress in the years ahead. These will include the identification of genetic markers to determine the hypertensive individuals with the greatest risk of death and of cardiovascular complications.

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Results of Treatment in Malignant Hypertension

Cited by 167 publications

References 19 publications

Nifedipine and Arotinolol in Combination for Accelerated-Malignant Hypertension: Results of One Year Follow-Up.

Nifedipine and Arotinolol in Combination for Accelerated-Malignant Hypertension: Results of One Year Follow-Up.

Significance of blood pressure levels achieved with felodipine anti-hypertensive treatment on cardiovascular structure and function changes

The treatment of hypertension

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