Some Different Types of Essential Hypertension: Their Course and Prognosis

Keith, Norman M.; Wagener, Henry P.; Barker, Nelson W.

doi:10.1097/00000441-197412000-00004

Cited by 562 publications

(361 citation statements)

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“…Retinal lesions were classified according to the Keith-Wagener-Barker classification. 15 The presence of retinal abnormalities, such as arteriolar narrowing and mild sclerosis (grade I), or widened arteriolar light reflex, moderate to marked sclerosis, and arterio-venous crossing (grade II) were considered markers of target organ damage. 10 …”

Section: Direct Ophthalmoscopymentioning

confidence: 99%

Creatinine clearance and signs of end-organ damage in primary hypertension

et al. 2004

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A reduction in renal function is associated with high cardiovascular morbidity and mortality in hypertension. The aim of the present study was to investigate the relationship between creatinine clearance and subclinical organ damage in 957 never previously treated, middle-aged patients with primary hypertension. Renal function was estimated by means of the serum creatinine level using the Cockcroft-Gault formula; left ventricular hypertrophy (LVH) was determined according to electrocardiographic criteria; and retinal vascular changes were evaluated by direct ophthalmoscopy. Creatinine clearance was, on the average, 83721.2 ml/ min, and the prevalence of LVH and retinopathy was 13 and 49%, respectively. Creatinine clearance was inversely related to the duration of disease (r ¼ À0.132, Po0.0001), systolic blood pressure (r ¼ À0.110, P ¼ 0.001), serum glucose (r ¼ À0.090, P ¼ 0.007), total cholesterol (r ¼ À0.196, Po0.0001), and LDL-cholesterol (r ¼ À0.196, Po0.0001). Patients in the lower quintile of creatinine clearance showed a higher prevalence of electrocardiogram (ECG) determined LVH (P ¼ 0.04), as well as retinal changes (P ¼ 0.02). The risk of having LVH or retinal vascular changes increases significantly with each s.d. decrease in creatinine clearance, regardless of traditional cardiovascular risk factors. Moreover, patients with ECG-determined LVH and retinal changes showed lower creatinine clearance as compared to those with lesser degrees of target organ involvement (Po0.01).In conclusion, a mild reduction in creatinine clearance is associated with preclinical end-organ damage in patients with normal creatinine and primary hypertension. These data may help explain the high cardiovascular mortality observed in patients with renal dysfunction. Routine evaluation of creatinine clearance could be useful for identifying patients at higher cardiovascular risk.

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Section: Direct Ophthalmoscopymentioning

confidence: 99%

Creatinine clearance and signs of end-organ damage in primary hypertension

et al. 2004

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“…The histological hallmark is fibrinoid necrosis of arterioles and severe vascular damage in many tissues including the kidney, and certainly, in early reports before the advent of modern antihypertensive therapy, around 80% of patients are dead within 2 years if the condition is left unrecognised or untreated. 1,2 The importance of early diagnosis is emphasised as patients tend to develop clinical symptoms only at a late stage of their disease.…”

Section: Introductionmentioning

confidence: 99%

Oxidative stress in malignant and non-malignant phase hypertension

et al. 2002

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Malignant hypertension (MHT) is a rare and severe form of hypertension characterised by arteriolar necrosis and severe vascular damage, leading to stroke, myocardial infarction and death. We hypothesised that in addition to endothelial damage, MHT may be associated with increased oxidative stress. Lipid hydroperoxides (LHP, an index of oxidative damage) and plasma von Willebrand factor (vWf, an index of endothelial damage/dysfunction) were measured in 16 patients with MHT and compared with 16 non-malignant essential hypertensives and 32 normotensive controls. vWf was greater in MHT (mean 117 iU/dL) than in non-malignant hypertensives (97 iU/dL) or normotensive controls (100 iU/dL) (ANOVA P = 0.017). However, although LHP were greater in MHT (mean 10.6 mol/L) than in normo-

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“…55 It was considered an essential criterion of malignant hypertension. 55 Traditionally papilloedema in hypertension has been considered to be a poor prognostic sign for survival.…”

Section: Hypertensive Optic Neuropathymentioning

confidence: 99%

Hypertension and the eye: changing perspectives

et al. 2002

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Systemic hypertension is a common condition associated with significant morbidity and mortality. Hypertension confers cardiovascular risk by causing target-organ damage that includes retinopathy in addition to heart disease, stroke, renal insufficiency and peripheral vascular disease. The recognition of hypertensive retinopathy is important in cardiovascular risk stratification of hypertensive individuals. This review reevaluates the changing perspectives in the pathophysiology, classification and prognostic significance of fundal lesions in hypertensives.

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Some Different Types of Essential Hypertension: Their Course and Prognosis

Cited by 562 publications

References 0 publications

Creatinine clearance and signs of end-organ damage in primary hypertension

Creatinine clearance and signs of end-organ damage in primary hypertension

Oxidative stress in malignant and non-malignant phase hypertension

Hypertension and the eye: changing perspectives

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