A follow-up was made of 69 patients diagnosed as having
malignant hypertension during 1969--76, essential in 26, secondary in 39 and unclassified in 4. A clear male dominance was seen (41 men, 28 women), particularly in the group with
essential hypertension (18 men, 8 women). The mortality in this series was less than in previously published series. Thus, the 5-year survival rate was 75% in the patients with essential and 72% in those with secondary
hypertension. In part this was due to haemodialysis and
renal transplantation. The importance of renal function at the time of diagnosis was evident in this study. In most patients with
essential hypertension and serum
creatinine levels below 300 mumol/l, renal function could be maintained or improved when
antihypertensive treatment was instituted, whereas progression of the renal damage was seen in those with serum
creatinine levels above 300 mumol/l in spite of
antihypertensive treatment with 3 or more drugs. The incidence of new cases of
malignant hypertension tended to decrease during the observation period, particularly as regards
essential hypertension.