Malignant Hypertension

A condition of markedly elevated BLOOD PRESSURE with DIASTOLIC PRESSURE usually greater than 120 mm Hg. Malignant hypertension is characterized by widespread vascular damage, PAPILLEDEMA, retinopathy, HYPERTENSIVE ENCEPHALOPATHY, and renal dysfunction.

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Networked: 638 relevant articles (25 outcomes, 45 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hypertension (High Blood Pressure)
2.	Renal Insufficiency (Renal Failure)
3.	Stroke (Strokes)
4.	Heart Failure
5.	Uremia

Experts

1.	Mitchell, Kenneth D: 15 articles (10/2013 - 10/2005)
2.	Mullins, John J: 14 articles (05/2011 - 02/2004)
3.	van Montfrans, Gert A: 7 articles (04/2013 - 10/2004)
4.	van den Born, Bert-Jan H: 7 articles (04/2013 - 10/2004)
5.	Kramer, Herbert J: 4 articles (12/2014 - 05/2009)
6.	Koopmans, Richard P: 4 articles (11/2007 - 10/2004)
7.	Mouton, Cynthia R: 4 articles (06/2007 - 10/2005)
8.	Sporková, Alexandra: 3 articles (12/2014 - 01/2011)
9.	Imig, John D: 3 articles (12/2014 - 01/2011)
10.	Kopkan, Libor: 3 articles (12/2014 - 01/2011)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Malignant Hypertension:

1.	Antihypertensive Agents (Antihypertensives)IBA 06/01/2015 - "Patients with malignant hypertension respond well to antihypertensive agents and have favorable nonrenal outcomes." 11/01/2006 - "The incidence of malignant hypertension has declined after the introduction of antihypertensive agents. " 07/01/2003 - "A 40 year-old man presented with episodic malignant hypertension resistant to several anti-hypertensive drugs. " 08/01/2000 - "A profound elevation of blood pressure on exercises or after withdrawal of antihypertensive drugs has been reported in patients with a history of accelerated-malignant hypertension. " 05/01/1997 - "A diagnosis of malignant hypertension was made and blood pressure was gradually controlled on oral antihypertensives. "
2.	Captopril (Capoten)FDA LinkGeneric 10/01/1981 - "We conclude that captopril, alone or in combination with other drugs, is effective in both the acute and long-term management of severe and malignant hypertension." 01/01/1984 - "In four patients with various forms of malignant hypertension and impairment of renal function, GFR remained unchanged or even increased when the blood pressure was reduced by captopril. " 03/01/1983 - "We studied the changes in mean arterial pressure (MAP), cardiac index (CI), pulmonary wedge pressure (PWP), and in plasma volume (PV) induced by a single oral dose of captopril (150 mg) in 11 patients with malignant hypertension. " 03/01/1983 - "Hemodynamic mechanism of blood pressure response to captopril in human malignant hypertension." 01/01/1983 - "Captopril was used in 21 patients with various forms of stable and malignant hypertension. "
3.	CalciumIBA 07/01/1999 - "From these finding, it is concluded that combination therapy with a calcium antagonist and alphabeta-blocker is effective in both the reduction of highly elevated blood pressure and protection of the kidneys, resulting in amelioration of accelerated-malignant hypertension." 12/01/1987 - "In malignant hypertension the deleterious calcium overload in tissues may be activated or inhibited independently of the regulation of arterial blood pressure." 01/01/1986 - "Calcium and malignant hypertension in animal experiment: effects of experimental manipulation of calcium influx." 01/01/1983 - "In experimental malignant hypertension these drugs preserve tissue integrity by inhibiting the deleterious calcium overload of vessels." 01/01/1991 - "It has also been proposed that nitrendipine is able to preserve tissue integrity and increase life span in malignant hypertension, because it prevents a deleterious calcium overload in the heart and arterial vessels. "
4.	Retinaldehyde (Retinal)IBA 04/01/1991 - "The lack of improvement in the ERG record points to a permanent lesion of the retinal activity after passed malignant hypertension in spite of normalization of the arterial pressure." 10/01/1985 - "Information about the retinal findings for the patients was requested and less than half of those in the national morbidity study proved to have a strict diagnosis of accelerated or malignant hypertension although they were originally recorded as patients with malignant hypertension. " 10/01/1946 - "Retinal and choroidal arterioles in malignant hypertension; a clinical and pathologic study of 15 cases." 01/01/2014 - "Adaptive optics assisted visualization of thickened retinal arterial wall in a patient with controlled malignant hypertension." 08/01/2012 - "A clinical trial of this system demonstrated that oximetry of the retinal capillaries may be an improvement over the present diagnosis for patients of malignant hypertension."
5.	DiureticsIBA 01/01/2003 - "Although useful as adjunctive therapy in hypertensive crises, diuretics should be used with caution in these patients because prior volume depletion may be present in some conditions such as malignant hypertension. " 04/01/1995 - "Clinical studies using diuretics and beta-blockers reported that thiazide treatment prevents the development of malignant hypertension, renal and heart failure, hypertensive retinopathy, and reduces in five years overall mortality of 33%, cardiovascular mortality of 41%, fatal and non-fatal cerebrovascular events of 51% and the risk of coronary events of 15%. " 06/01/1982 - " The use of diuretics, antisympathetic agents, vasodilators, and parenteral agents for malignant hypertension represents an appropriate sequence to follow in such cases." 10/01/1990 - "The drugs used in early studies - diuretics, vasodilators and reserpine - greatly improved mortality from malignant hypertension, apoplectic stroke and congestive heart failure, but had little or no effect in persons with milder degrees of elevated blood pressure, who constitute the vast majority of hypertensives. "
6.	Nitric Oxide (Nitrogen Monoxide)FDA Link 02/01/2013 - "The present study was performed to investigate in a model of malignant hypertension if the antihypertensive actions of soluble epoxide hydrolase (sEH) inhibition are nitric oxide (NO)-dependent. " 01/01/2011 - "Novel sGC stimulators, including riociguat (BAY 63-2521), have a dual mode of action: They sensitize sGC to endogenously produced nitric oxide (NO) and also directly stimulate sGC independently of NO. Little is known about their effects on tissue remodeling and degeneration and survival in experimental malignant hypertension. " 01/01/2008 - "Renoprotective effects of neuronal NOS-derived nitric oxide and cyclooxygenase-2 metabolites in transgenic rats with inducible malignant hypertension." 10/01/2005 - "These findings indicate that superoxide anion contributes to the elevated RVR and increased arterial blood pressure, by a mechanism that is at least in part nitric oxide dependent, in Cyp1a1-Ren2 rats with malignant hypertension." 10/01/2005 - "Interactive effects of superoxide anion and nitric oxide on blood pressure and renal hemodynamics in transgenic rats with inducible malignant hypertension."
7.	Reserpine (Serpasil)FDA Link 05/01/1961 - "[The effect of reserpine (serpasil) on kidney function in malignant hypertension]." 10/01/1954 - "[Effects of reserpine on chronic malignant hypertension]." 06/20/1959 - "Mecamylamine and reserpine in the management of severe and malignant hypertension in Uganda." 10/01/1990 - "The drugs used in early studies - diuretics, vasodilators and reserpine - greatly improved mortality from malignant hypertension, apoplectic stroke and congestive heart failure, but had little or no effect in persons with milder degrees of elevated blood pressure, who constitute the vast majority of hypertensives. "
8.	Vasodilator Agents (Vasodilators)IBA 12/01/1983 - "In emergency situations with malignant hypertension more powerful vasodilators like diazoxid or Nitroprussid Sodium are necessary. " 06/01/1982 - " The use of diuretics, antisympathetic agents, vasodilators, and parenteral agents for malignant hypertension represents an appropriate sequence to follow in such cases." 10/01/1990 - "The drugs used in early studies - diuretics, vasodilators and reserpine - greatly improved mortality from malignant hypertension, apoplectic stroke and congestive heart failure, but had little or no effect in persons with milder degrees of elevated blood pressure, who constitute the vast majority of hypertensives. "
9.	imatinib (Gleevec)FDA Link 01/01/2012 - "Imatinib ameliorates renal morphological changes in Cyp1a1-Ren2 transgenic rats with inducible ANG II-dependent malignant hypertension." 01/01/2012 - "The present study was performed to assess the effects of the platelet-derived growth factor (PDGF) receptor kinase inhibitor imatinib mesylate on the renal morphological changes occurring during the development of malignant hypertension in transgenic rats with inducible expression of the Ren2 gene [TGR(Cyp1a1Ren2)]. "
10.	CreatinineIBA 08/01/1980 - "The longest period of follow-up was five years, and one patient achieved a creatinine clearance of 23 ml/min. Renal histology, available in five cases, showed changes of malignant hypertension only, with no evidence of other renal lesions. " 10/01/1989 - "Although the pretreatment serum creatinine levels were matched, the renal function more rapidly deteriorated after development of malignant hypertension in the CGN group than did in the EHT group, indicating renal survival rate to be shorter in the former group. " 01/01/1990 - "The following covariates were entered into the Cox's model: sex, duration of hypertension before malignant phase, age, serum creatinine, stages 3 and 4 fundi, diastolic blood pressure, cardiac and neurological involvements, extrarenal atheromatous disease, aetiology of the malignant hypertension (primary, secondary to parenchymal nephropathy, and secondary to renovascular abnormalities), all these covariates being recorded during the initial admission; and mean diastolic blood pressure during the period the patients were observed. " 06/01/1988 - "We report on a 45 years old woman with malignant hypertension (220/135 mmHg, severe retinopathy with papilledema, progressive renal insufficiency with serum creatinine over 300 mumol/l) of recent onset. " 01/01/1988 - "(3) The hyperperfusion injury was seen as a complication of glomerulonephritis or diabetic glomerulosclerosis only when the patient clinically had developed malignant hypertension and when the serum creatinine level was elevated, a sign of compensated retention. "

Therapies and Procedures

1.	Nephrectomy 12/19/1959 - "Malignant hypertension and hypokalaemia: cured by nephrectomy." 10/20/1956 - "Irradiation-induced malignant hypertension: cured by nephrectomy." 09/01/1956 - "Malignant hypertension in a girl of 15 relieved by nephrectomy." 07/01/1945 - "MALIGNANT HYPERTENSION CURED BY UNILATERAL NEPHRECTOMY." 01/01/2012 - "Bilateral nephrectomy as a rescue therapy for hemodialyzed patient with malignant hypertension - case report."
2.	Renal Dialysis (Hemodialysis) 11/01/1980 - "Four of nine patients presenting with malignant hypertension had marked and sustained improvement in renal function, although three initially required hemodialysis. " 12/08/1979 - "Following effective long-term antihypertensive therapy, hemodialysis could be discontinued in 4 patients with malignant hypertension in view of improved renal function. " 01/01/2000 - "Clinical diagnosis of malignant hypertension was given and antihypertensive therapy and hemodialysis were immediately started. " 01/01/1999 - "In conclusion, previous malignant hypertension did not increase the risk of patients in long-term hemodialysis in our series." 01/01/1992 - "[Hemodialysis therapy of malignant hypertension]."
3.	Transplantation (Transplant Recipients) 04/01/1981 - "[Effect of the resection of native kidneys in transplant recipients with malignant hypertension]." 01/01/1978 - "All cases of malignant hypertension required removal of primary kidneys, either before or after transplantation. " 04/01/1991 - "Ophthalmological examinations were carried out in 42 patients (aged 16-45 years) after kidney transplantation in whom malignant hypertension was discovered before transplantation. " 06/01/1980 - "Few therapeutic advances of proven efficacy have been forthcoming over this period except for the use of vigorous antihypertensive therapy or early nephrectomy, dialysis, and transplantation in the control of malignant hypertension and progressive renal failure." 01/01/1988 - "All patients presented a renal or renovascular disease (acute nephritis + hypoplastic dysplasia , transplantation = 58%) for which malignant hypertension was the first symptom in 16%. "
4.	Sympathectomy (Sympathectomies) 08/26/2014 - "Surgical sympathectomy was the treatment of choice for malignant hypertension and it significantly improved mortality. " 04/26/2013 - "Large reductions in blood pressure were also observed in malignant hypertension patients submitted to sympathectomy surgeries. " 11/01/2012 - "In the past surgical sympathectomy with extended removal of sympathetic ganglia was performed to reduce blood pressure in patients with malignant hypertension. " 01/01/1968 - "Reevaluation of thoracic sympathectomy for the management of malignant hypertension." 07/01/1963 - "THORACO-LUMBAR SYMPATHECTOMY AND MALIGNANT HYPERTENSION: REVIEW OF TWENTY CASES."
5.	Intravitreal Injections 05/01/2011 - "To report a case of retinopathy secondary to malignant hypertension showing a macular star, which responded favorably to a single intravitreal injection of bevacizumab (IVB). " 05/01/2011 - "Intravitreal injection of bevacizumab can be a useful approach to treat the exudative manifestations of malignant hypertension."