Malignant Hypertension

  • C. G. Isles
Part of the New Clinical Applications Nephrology book series (NCNG)


Clinicians who manage patients with malignant hypertension (MHT) have witnessed some remarkable changes in recent years. The incidence of the disease appears to have fallen, at least in the U.K. and other Western countries1. Reduction of blood pressure within minutes by parenteral therapy is no longer recommended as a routine procedure, and it is now recognized that initial management is best achieved by one or two drugs given orally in most cases2. Moreover, survival has improved as a result of more effective antihypertensive drug therapy and the increasing availability of renal dialysis and transplantation3–6.


Central Retinal Vein Occlusion Malignant Hypertension Hypertensive Emergency Progressive Systemic Sclerosis Scleroderma Renal Crisis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Kincaid-Smith, P. (1985). What has happened to malignant hypertension? In Bulpitt, C. J. (ed). Handbook of Hypertension, Vol 6, Epidemiology of Hypertension, pp. 225–65. (Amsterdam: Elsevier)Google Scholar
  2. 2.
    Ledingham, J.G.G. (1983). Management of hypertensive crises. Hypertension., 5 (Suppl. III), 114–19Google Scholar
  3. 3.
    Gudbrandsson, T., Hansson, L., Herlitz, H. and Andren, L. (1979). Malignant hypertension—improving prognosis in a rare disease. Acta Med, Scand., 206, 495–9PubMedGoogle Scholar
  4. 4.
    Isles, C. G., Lim, K. G., Boulton-Jones, M., Cameron, H., Lever, A. F., Murray, G. and Robertson, J.W. K. (1985). Factors influencing outcome in malignant hypertension. J. Hypertension., 3, (Suppl. 3), S405–7Google Scholar
  5. 5.
    Yu, S.H., Whitworth, J. A. and Kincaid-Smith, P.S. (1986). Malignant hypertension: etiology and outcome in eighty-three patients. Clin. Exp. Hypertension A8, 1211–30Google Scholar
  6. 6.
    Bing, R.F., Heagerty, A.M., Russell, G.I., Swales, J.D. and Thurston, H. (1986). Prognosis in malignant hypertension. J. Hypertension 4 (Suppl. 6), S42–S44Google Scholar
  7. 7.
    Jhetam, D., Dansey, R., Morar, C., and Milne, F.J. (1982). The malignant phase of essential hypertension in Johannesburg blacks. S. Afr. Med. J., 61, 899–902PubMedGoogle Scholar
  8. 8.
    World Health Organisation (1978). Arterial hypertension. WHO Tech. Rep. Ser. 628, 57Google Scholar
  9. 9.
    Pickering, G. W. (1968). High blood pressure (London: Churchill)Google Scholar
  10. 10.
    Reubi, F. (1974). Malignant hypertension. Clin. Nephrol., 2, 211–14PubMedGoogle Scholar
  11. 11.
    Kincaid-Smith, P. (1981). Understanding malignant hypertension. Austr. N. Z. J. Med. 11, (Suppl. 1), 64–8Google Scholar
  12. 12.
    Schottstaedt, M. F. and Sokolow, M. (1953). The natural history and course of hypertension with papilledema (malignant hypertension). Am. Heart. J., 45, 331–62PubMedGoogle Scholar
  13. 13.
    Kincaid-Smith, P., McMichael, J. and Murphy E. A. (1958). The clinical course and pathology of hypertension with papilledema (malignant hypertension). Q. J. Med., 27, 117–53PubMedGoogle Scholar
  14. 14.
    Gifford, R. W. (1983). Management and treatment of essential hypertension including malignant hypertension and emergencies. In Genest, J., Kuchel, O., Hamet, P., and Cantin, M. (Eds). Hypertension: physiopathology and treatment, 2nd Edn pp. 1127–70. (New York: McGraw-Hill)Google Scholar
  15. 15.
    Brown, J. J., Davies, D. L., Lever, A. F., and Robertson, J. I. S. (1966). Plasma renin concentration in human hypertension III: renin in relation to complications of hypertension. Br. Med. J., 1, 505–8PubMedGoogle Scholar
  16. 16.
    McLeod, D., Marshall, J. and Kohner, E. M. (1980). Role of axoplasmic transport in the pathophysiology of ischaemic disc swelling. Br. J. Ophthalmol., 64, 247–61PubMedGoogle Scholar
  17. 17.
    Wrong, O. (1986). Retinal changes in malignant/accelerated hypertension. Br. Med. J., 1, 483Google Scholar
  18. 18.
    McGregor, E., Isles, C.G., Jay, J.L., Lever, A. F. and Murray, G.D. (1986). Retinal changes in malignant hypertension. Br. Med. J. 1, 233–4Google Scholar
  19. 19.
    Ahmed, M.E.K., Walker, J.M., Beevers, D.G. and Beevers, M. (1986). Lack of difference between malignant and accelerated hypertension. Br. Med. J., 1 235–7Google Scholar
  20. 20.
    Lindop, G. (1985). Blood vessels and lymphatics. In Anderson, J. R. (Ed.) Muir’s textbook of pathology, 12th Edn Chap. 14. (Edinburgh: Edward Arnold)Google Scholar
  21. 21.
    Beilin, L.J. and Goldby, F.S. (1977). High arterial pressure versus humoral factors in the pathogenesis of vascular lesions of malignant hypertension: the case for pressure alone. Clin. Sci., 52, 111–13Google Scholar
  22. 22.
    Gudbrandsson, T., Hansson L., Herlitz, H., Lindholm L. and Nilsson L. A. (1981). Immunological changes in patients with previous malignant essential hypertension. Lancet., 1, 406–8PubMedGoogle Scholar
  23. 23.
    Gavras, H., Oliver, N., Aitchison, J., Begg, C., Briggs, J. D., Brown, J. J., Horton, P. W., Lee, F., Lever, A. F., Prentice, C. R. M. and Robertson, J. I. S. (1975). Abnormalities of coagulation and the development of malignant phase hypertension. Kidney Int 8, S252–61Google Scholar
  24. 24.
    Isles, C.G., Lowe, G.D.O., Rankin, B.M., Forbes, C.D., Lucie, N., Lever, A. F. and Kennedy, A. C. (1984). Abnormal haemostasis and blood viscosity in malignant hypertension. Thromb. Haemostas., 52, 253–5Google Scholar
  25. 25.
    Isles, C. G., Brown, J. J., Cumming, A. M.M., Lever, A. F., McAreavey, D., Robertson, J. I. S., Hawthorne, V. M., Stewart, G. M., Robertson, J. W. K. and Wapshaw, J. (1979). Excess smoking in malignant phase hypertension. Br. Med. J., 1, 579–81PubMedGoogle Scholar
  26. 26.
    Bloxham, C.A., Beevers, D.G. and Walker, J.M. (1979). Malignant hypertension and cigarette smoking. Br. Med. J., 1, 581–3PubMedGoogle Scholar
  27. 27.
    Harris, P. W. R. (1969). Malignant hypertension associated with oral contraceptives. Lancet., 2, 466–7PubMedGoogle Scholar
  28. 28.
    Giese, J. (1976). The renin-angiotensin system and the pathogenesis of vascular disease in malignant hypertension. Clin. Sci., 51, 19s—21sGoogle Scholar
  29. 29.
    Mohring, J. (1977). High arterial pressure versus humoral factors in the pathogenesis of vascular lesions of malignant hypertension: the case for humoral factors as well as pressure. Clin Sci., 52, 113–17Google Scholar
  30. 30.
    Geise, J. (1964). Acute hypertensive vascular disease, 2. Studies on vascular reaction patterns and permeability changes by means of vital microscopy and celloidal tracer technique. Acta Pathol. Microbiol. Scand., 62, 497–515Google Scholar
  31. 31.
    Ross, R. and Glomsett, J. A. (1973). Atherosclerosis and the arterial smooth muscle cell: proliferation of smooth muscle is a key event in the genesis of lesions of atherosclerosis. Science., 180, 1332–9PubMedGoogle Scholar
  32. 32.
    Linton, A.L., Gavras, H., Gleadle, R. I., Hutchison, H.E., Lawson, D. H., Lever, A. F., MacAdam, R. F., McNicol, G.P. and Robertson, J.I.S. (1969). Microangiopathic haemolytic anaemia and the pathogenesis of malignant hypertension. Lancet., 1, 1277–82PubMedGoogle Scholar
  33. 33.
    Robertson, J. I. S. (1986). Hypertension in the elderly. Triangle., 25, 19–23Google Scholar
  34. 34.
    Lee, T. H and Alderman, M.H. (1978). Malignant hypertension: declining mortality rate in New York city, 1958–1974. N.Y. State J. Med., 78, 1389–91PubMedGoogle Scholar
  35. 35.
    Davis, B.A., Crook, J.E., Vestal, R.E. and Oates, J. A. (1979). Prevalence of renovascular hypertension in patients with grade III or IV hypertensive retinopathy. N. Engl. J. Med., 301, 1273–6PubMedGoogle Scholar
  36. 36.
    Ferris, J. B., Beevers, D. G., Brown, J. J., Davies, D. L., Fraser, R., Lever, A. F., Mason, P., Neville, A. M., Robertson, J. I. S. (1978). Clinical, biochemical and pathological features of low-renin (primary) hyperaldosteronism. Am. Heart J., 95, 375–88Google Scholar
  37. 37.
    Murphy, B. F., Whitworth, J. A and Kincaid-Smith, P. (1985). Malignant hypertension due to an aldosterone producing adrenal adenoma. Clin. Exp. Hypertension A7, 939–50Google Scholar
  38. 38.
    Gold, C. H., Isaacson, C., and Levin, J. (1982). The pathological basis of end stage renal disease in blacks. S. Afr. Med. J., 61, 263–5PubMedGoogle Scholar
  39. 39.
    Sinclair, A. M., Isles, C. G., Brown, I., Cameron, H., Murray, G. D., Robertson, J.W.K. and Wapshaw, J. (1987). Secondary hypertension in a blood pressure clinic. Arch. Intern. Med., 147, 1289–93PubMedGoogle Scholar
  40. 40.
    Seltzer, C. C. (1974). Effect of smoking on blood pressure. Am. Heart. J., 87, 558–64PubMedGoogle Scholar
  41. 41.
    Freestone, S. and Ramsay, L. E. (1982). Effect of coffee and cigarette smoking on the blood pressure of untreated and diuretic-treated hypertensive patients. Am. J. Med., 73, 348–53PubMedGoogle Scholar
  42. 42.
    MRC Working Party. (1985). Medical Research Council Trial of treatment of mild hypertension: principal results. Br. Med. J., 2, 97–104Google Scholar
  43. 43.
    Elliott, J. M. and Simpson, F. O. (1980). Cigarettes and accelerated hypertension. N.Z. Med. J., 91, 447–9PubMedGoogle Scholar
  44. 44.
    Tuomilehto, J., Elo, J. and Nissmen, A. (1982). Smoking among patients with malignant hypertension. Br. Med. J., 1, 1086Google Scholar
  45. 45.
    Royal College of Physicians (1977). Smoking or health Third Report. (London: Pitman Medical)Google Scholar
  46. 46.
    Zacherle, B. J. and Richardson, J. A. (1972). Irreversible renal failure secondary to hypertension induced by oral contraceptives. Ann. Intern. Med., 77, 83–5PubMedGoogle Scholar
  47. 47.
    Dunn, F. G., Jones, J. V. and Fife, R. (1975). Malignant hypertension associated with use of oral contraceptives. Br. Heart J., 37, 336–8PubMedGoogle Scholar
  48. 48.
    Zech, P., Rifle, G., Lindner, A., Sassard, J., Blanc-Brunat, N. and Traeger, J. (1975). Malignant hypertension with irreversible renal failure due to oral contraceptives. Br. Med. J., 4, 326–7PubMedGoogle Scholar
  49. 49.
    Saint Hillier, Y., Baumont, N., Colomb, H., Pageaut, G. and Perol, C. (1977). Hypertension arterielle maligne et contraceptifs oraux. J. Urol. Nephrol. (Paris), 83, 673–9Google Scholar
  50. 50.
    Hodsman, G.P., Robertson, J.I.S., Semple, P.F. and MacKay, A. (1982). Malignant hypertension and oral contraceptives: four cases, with two due to the 30//g oestrogen pill. Eur. Heart J., 3, 255–9PubMedGoogle Scholar
  51. 51.
    Pettiti, D. B. and Klatsky, A. L. (1983). Malignant hypertension in women aged 15–44 years and its relation to cigarette smoking and oral contraceptives. Am. J. Cardiol., 52, 297–8Google Scholar
  52. 52.
    Lim, K. G., Isles, C. G., Hodsman, G. P., Lever, A. F. and Robertson, J. W. K. (1987). Malignant hypertension in women of childbearing age and its relation to the oral contraceptive pill. Br. Med. 1, 1057–9Google Scholar
  53. 53.
    Mammen, E. F. (1982). Oral contraceptives and blood coagulation: a critical review. Am. J. Obstet. Gynaecol., 142, 781–90Google Scholar
  54. 54.
    Golbus, S. M., Swerdlin, A. R., Mitas, J. A., Rowley, W. R., James, D. R. (1979). Renal artery thrombosis in a young woman taking oral contraceptives. Ann. Intern. Med., 90, 939–940PubMedGoogle Scholar
  55. 55.
    Boyd, W. N., Burden, R. P. and Aber, G. M. (1975). Intrarenal vascular changes in patients receiving oestrogen containing compounds—a clinical, histological and angiographic study. Q. J. Med., 44, 415–31PubMedGoogle Scholar
  56. 56.
    Sleight, P. (1984). Hypertension. In Weatherall, D. J., Ledingham, J. G. G. and Warrell, D. A. (Eds.) Oxford Textbook of Medicine, Vol 2, pp. 258–78 (Oxford: Oxford University Press)Google Scholar
  57. 57.
    Ying, C. Y., Tifft, C.P., Gavras, H. and Chobanian, A. V. (1984). Renal revascularisation in the azotaemic hypertensive patient resistant to therapy. N. Engl. J. Med., 311, 1070–5PubMedGoogle Scholar
  58. 58.
    Gudbrandsson, T., Swertsson, R., Herlitz, H. and Hansson, L. (1982). Cardiac involvement in hypertension: a non invasive study of patients with previous malignant hypertension and ’benign’ hypertension. Eur. Heart J., 3, 246–54PubMedGoogle Scholar
  59. 59.
    Shapiro, L. M., MacKinnon, J. and Beevers, D.G. (1981). Echocardiographic features of malignant hypertension. Br. Heart J., 46, 374–9PubMedGoogle Scholar
  60. 60.
    Healton, E. B., Brust, J. C., Feinfield, D. A. and Thomson, G. E. (1982). Hypertensive encephalopathy and the neurological manifestations of malignant hypertension. Neurology., 32, 127–32PubMedGoogle Scholar
  61. 61.
    Bahemuka, M. (1985). Malignant hypertension: a review of the neurological features in 34 consecutive patients. E. Afr. Med. J., 62, 560–5Google Scholar
  62. 62.
    Barcenas, C.G., Gonzales-Molina, M., and Hull, A. R. (1978). Association between acute pancreatitis and malignant hypertension with renal failure. Arch. Intern. Med. 138, 1254–6PubMedGoogle Scholar
  63. 63.
    Padfield, P. L. (1975). Malignant hypertension presenting with an acute abdomen. Br. Med. J., 3, 353–4PubMedGoogle Scholar
  64. 64.
    Dollery, C.T. (1983). Hypertensive retinopathy. In Genest, J., Kuchel, O., Hamet, P. and Cantin, M. (Eds.) Hypertension: Physiopathology and Treatment, 2nd Edn pp. 723–32. (Toronto: MacGraw-Hill)Google Scholar
  65. 65.
    Breslin, D.J., Ray, M.D., Gifford, R.W., Fairbairn, J. F. and Kearns, T.P. (1966). Prognostic importance of ophthalmoscopic findings in essential hypertension. J. Am. Med. Assoc. 195, 335–8Google Scholar
  66. 66.
    Pears, M.A. and Pickering, G. W. (1960). Changes in the fundus oculi after haemorrhage. Q. J. Med., 29, 153–80PubMedGoogle Scholar
  67. 67.
    Ballantyne, A.J. and Michaelson, I.C. (1962). Disorders of blood and blood forming organs. Textbook of the Fundus and Eye pp. 216–25. (Edinburgh: Livingstone)Google Scholar
  68. 68.
    Knowler, W.C., Bennett, P.H. and Ballintine, E.J. (1980). Increased incidence of retinopathy in diabetics with elevated blood pressure. N. Engl. J. Med., 302, 645–50PubMedGoogle Scholar
  69. 69.
    Strandgaard, S. and Paulson, O. B. (1984). Cerebral autoregulation. Stroke, 15, 413–16PubMedGoogle Scholar
  70. 70.
    Graham, D. I., Lee, W. R., Cumming, A. M. M., Robertson, J. I. S. and Jones, J.V. (1983). Hypertension and the intracranial and intraoccular circulations: effects of antihypertensive treatment. In Robertson, J. I. S. (Ed.) Handbook of Hypertension, Vol. Clinical Aspects of Essential Hypertension pp. 174–201. (Amsterdam: Elsevier)Google Scholar
  71. 71.
    Graham, D. I. (1975). Ischaemic brain damage of cerebral perfusion failure type following treatment of severe hypertension: a report of two cases. Br. Med. J., 2, 739Google Scholar
  72. 72.
    Ledingham, J. G. G. and Rajagopalan, B. (1979). Cerebral complications in the treatment of accelerated hypertension. Q. J. Med., 48, 25–41PubMedGoogle Scholar
  73. 73.
    Cove, D.H., Seddon, M., Fletcher, R.F. and Dukes, D.C. (1979). Blindness after treatment for malignant hypertension. Br. Med. J., 2, 245–6PubMedGoogle Scholar
  74. 74.
    Hulse, J. A., Taylor, D.S.I. and Dillon, M.J. (1979). Blindness and paraplegia in severe childhood hypertension. Lancet., 2, 553–6PubMedGoogle Scholar
  75. 75.
    Isles, C. G., Johnston, A. O. C. and Milne, F. J. (1986). Slow release Nifedipine and Atenolol as initial treatment in blacks with malignant hypertension. Br. J. Clin, Pharmacol., 21, 377–83Google Scholar
  76. 76.
    Bannan, L. P. and Beevers, D. G. (1981). Emergency treatment of high blood pressure with oral Atenolol. Br. Med. J., 1, 1757–8Google Scholar
  77. 77.
    Bertel, P., Conen, D., Radu, E.W., Muller, J., Lang, C. and Dubach, U.C. (1983). Nifedipine in hypertensive emergencies. Br. Med. J., 1, 19–21Google Scholar
  78. 78.
    Merrill, J. P. (1962). Hypertensive vascular disease. In Harrison, T. R., Resnik, W. R., Wintrobe, M. M., Thorn, G. W., Adams, R. D. and Bennett, I. L. (Eds.) Principles of Internal Medicine, p. 1359. (New York: McGraw-Hill)Google Scholar
  79. 79.
    Mailloux, L.U., Mossey, R.T., Susin, M. and Teichberg, S. (1981). Does treatment of hypertension prevent renal failure? Clin. Exp. Dial. Apher., 5, 197— 212Google Scholar
  80. 80.
    Vidt, D. G., Bravo, E. L. and Fouad, F. M. (1982). Drug therapy: Captopril. N. Engl. J. Med., 306, 214–8PubMedGoogle Scholar
  81. 81.
    Abe, I., Kawasaki, T., Kawazoe, N. and Omae, T. (1983). Acute electrocardiographic effects of captopril in the initial treatment of malignant or severe hypertension. Am. Heart J., 106, 558–62PubMedGoogle Scholar
  82. 82.
    Vidt, D.G. and Gifford, R.W. (1984). A compendium for the treatment of hypertensive emergencies. Cleve. Clin. Q., 51, 421–30PubMedGoogle Scholar
  83. 83.
    Dinsdale, H. B. (1982). Hypertensive encephalopathy. Stroke., 13, 717–19PubMedGoogle Scholar
  84. 84.
    Palmer, R.F. and Lasseter, K.C. (1975). Sodium nitroprusside. N. Engl. J. Med., 292, 294–7PubMedGoogle Scholar
  85. 85.
    Cummings, A. M.M., Brown, J. J., Fraser, R., Lever, A. F., Morton, J. J., Richards, D.A. and Robertson, J. I.S. (1979). Blood pressure reduction by incremental infusion of labetalol in patients with severe hypertension. Br. J. Clin. Pharmacol., 8, 359–64PubMedGoogle Scholar
  86. 86.
    Dunn, F. G. (1983). Hypertension and myocardial infarction. J. Am. Coll. Cardiol., 1, 528–32PubMedGoogle Scholar
  87. 87.
    Dye, L. E., Urthaler, F., MacLean, W. A. H., Russell, R. O., Rackley, C. E. and James, T.N. (1978). New arterial hypertension during myocardial infarction. South. Med. J., 71, 289–92PubMedGoogle Scholar
  88. 88.
    ISIS-1 (First international study of infarct survival) Collaborative group (1986). Randomised trial of intravenous atenolol among 16,027 cases of suspected acute myocardial infarction: ISIS-1. Lancet., 2, 57–66Google Scholar
  89. 89.
    Ball, S.G. (1984). Phaeochromocytoma. In Robertson, J.I.S. (Ed.) Handbook of Hypertension, Vol. II, Clinical Aspects of Secondary Hypertension, pp. 238–75 (Amsterdam: Elsevier)Google Scholar
  90. 90.
    Agabiti-Rosei, E., Brown, J.J., Lever, A.F., Morton, J.J., Robertson, A.M., Robertson, J. I.S. and Trust, P.M. (1976). Treatment of phaeochromocytomaand of clonidine withdrawal hypertension with labetalol. Br. J. Clin. Pharmacol., 3, (Suppl. 3), 809–15Google Scholar
  91. 91.
    Jones, D. J. and Durning, P. (1985). Phaeochromocytoma presenting as an acute abdomen: report of two cases. Br. Med. J., 2, 1267–8Google Scholar
  92. 92.
    Shapiro, L. M., Trethowan, N. and Singh, S. P. (1982).-Normotensive cardiomyopathy and malignant hypertension in phaeochromocytoma. Postgrad. Med. J., 58, 110–11PubMedGoogle Scholar
  93. 93.
    Editorial (1978). Controlled intravascular nitroprusside treatment. Br. Med. J., 2, 784–5Google Scholar
  94. 94.
    Steen, V.D., Medsger, T.A., Osial, T.A., Ziegler, G.L., Shapiro, A. P. and Rodnan, G. P. (1984). Factors predicting development of renal involvement in progressive systemic sclerosis. Am. J. Med., 76, 779–86PubMedGoogle Scholar
  95. 95.
    Ponticelli, C., Ambroso, G., Graziani, G., Rossi, E. (1980). Reversible acute renal failure in diffuse scleroderma. Clin. Nephrol., 13, 293–5PubMedGoogle Scholar
  96. 96.
    Zawada, E. T., Clements, P. J., Furst, D. A., Bloomer, A., Paulus, H. E and Maxwell, M. H. (1981). Clinical course of patients with scleroderma renal crisis treated with Captopril. Nephron., 27, 74–8PubMedGoogle Scholar
  97. 97.
    Chapman, P. J., Pascoe, M.D. and Van Zyl-Smit, R. (1986). Successful use of Captopril in the treatment of scleroderma renal crisis. Clin. Nephrol., 26, 106–8PubMedGoogle Scholar
  98. 98.
    Mitnick, P. D. and Feig, P. U. (1978). Control of hypertension and reversal of renal failure in scleroderma. N. Engl. J. Med., 299, 871–2Google Scholar
  99. 99.
    Simon, N. M., Graham, M. B., Kyser, F. A. and Gashti, E. N. (1979). Resolution of renal failure with malignant hypertension in scleroderma. Am. J. Med., 67, 533–9PubMedGoogle Scholar
  100. 100.
    Traub, Y. M., Shapiro, A. P., Osial, T. A., Rodnan, G. P., Medsger, T. A., Leb, D. E. and Christy, W.C. (1981). Response of patients with renal involvement by progressive systemic sclerosis to antihypertensive therapy. Clin. Sci., 61, 395s-8sPubMedGoogle Scholar
  101. 101.
    Richardson, J. A. (1973). Haemodialysis and kidney transplantation for renal failure from scleroderma. Arthritis Rheum., 16, 265–71PubMedGoogle Scholar
  102. 102.
    Lam, M., Ricanati, E. S., Khan, M.A. et al (1978). Reversal of severe renal failure in systemic sclerosis. Ann. Intern. Med., 89, 642–3PubMedGoogle Scholar
  103. 103.
    Doroghazi, R.M., Slater, E.E. and De Sanctis, R.W. (1981). Medical therapy for aortic dissections. J. Cardiovasc. Med. 6, 187–98Google Scholar
  104. 104.
    Najafi, H. (1983). Aortic dissection. In Sabiston, D. C. and Spencer, F. C. (Eds.) Surgery of the Chest 4th Edn., pp. 956–67. (Philadelphia: W. B. Saunders)Google Scholar
  105. 105.
    Keith, N.M., Wagener, H.P. and Barker, N.W. (1939). Some different types of essential hypertension: their course and prognoses. Am. J. Med. Sci., 197, 332–43Google Scholar
  106. 106.
    Breckenridge, A., Dollery, C. T. and Parry, E. H. O. (1970). Prognosis of treated hypertension: changes in life expectancy and causes of death between 1952 and 1967. Q. J. Med. 39, 411–29PubMedGoogle Scholar
  107. 107.
    Lawton, W.J. (1982). The short term course of renal function in malignant hypertensives with renal insufficiency. Clin. Nephrol., 17, 277–83PubMedGoogle Scholar
  108. 108.
    Woods, J. W. and Blythe, W. B. (1967). Management of malignant hypertension complicated by renal insufficiency. N. Engl. J. Med. 277, 57–61PubMedGoogle Scholar
  109. 109.
    Mroczek, W. J., Davidov, M., Gavrilovich, L. and Finnerty, F. A. (1969). The value of aggressive therapy in the hypertensive patient with azotaemia. Circulation., 40, 893–904Google Scholar
  110. 110.
    Pohl, J.E.F., Thurston, H. and Swales, J.D. (1974). Hypertension with renal impairment: influence of intensive therapy. Q. J. Med., 43, 569–81PubMedGoogle Scholar
  111. 111.
    Sevitt, L.H., Evans, D. J. and Wrong, O. M. (1971). Acute oliguric renal failure due to accelerated (malignant) hypertension. Q. J. Med., 40, 127–44PubMedGoogle Scholar
  112. 112.
    Mamdani, B. H., Lim, V. S., Mahurkar, S. D., Katz, A. I. and Dunea, G. (1974). Recovery from prolonged renal failure in patients with accelerated hypertension. N. Engl. J. Med., 291, 1343–4PubMedGoogle Scholar
  113. 113.
    Cordingley, F.T., Jones, N.F., Wing, A.J. and Hilton, P.J. (1980). Reversible renal failure in malignant hypertension. Clin. Nephrol., 14, 98–103PubMedGoogle Scholar
  114. 114.
    Isles, C. G., McLay, A. and Boulton-Jones, J. M. (1984). Recovery in malignant hypertension presenting as acute renal failure. Q. J. Med., 53, 439–52PubMedGoogle Scholar

Copyright information

© MTP Press Limited 1998

Authors and Affiliations

  • C. G. Isles

There are no affiliations available

Personalised recommendations