Boulestreau, Romain; Śpiewak, Mateusz; Januszewicz, Andrzej; Kreutz, Reinhold; Guzik, Tomasz J; Januszewicz, Magdalena; Muiesan, Maria Lorenza; Persu, Alexandre; Sarafidis, Pantelis; Volpe, Massimo; Zaleska-Żmijewska, Anna; van den Born, Bert-Jan H; Messerli, Franz H (2024). Malignant Hypertension:A Systemic Cardiovascular Disease: JACC Review Topic of the Week. Journal of the American College of Cardiology, 83(17), pp. 1688-1701. Elsevier 10.1016/j.jacc.2024.02.037
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Malignant hypertension (MHT) is a hypertensive emergency with excessive blood pressure (BP) elevation and accelerated disease progression. MHT is characterized by acute microvascular damage and autoregulation failure affecting the retina, brain, heart, kidney, and vascular tree. BP must be lowered within hours to mitigate patient risk. Both absolute BP levels and the pace of BP rise determine risk of target-organ damage. Nonadherence to the antihypertensive regimen remains the most common cause for MHT, although antiangiogenic and immunosuppressant therapy can also trigger hypertensive emergencies. Depending on the clinical presentation, parenteral or oral therapy can be used to initiate BP lowering. Evidence-based outcome data are spotty or lacking in MHT. With effective treatment, the prognosis for MHT has improved; however, patients remain at high risk of adverse cardiovascular and kidney outcomes. In this review, we summarize current viewpoints on the epidemiology, pathogenesis, and management of MHT; highlight research gaps; and propose strategies to improve outcomes.
Item Type: |
Journal Article (Review Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Kardiologie 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Kardiologie 04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Messerli, Franz |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1558-3597 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
25 Apr 2024 09:32 |
Last Modified: |
26 Apr 2024 15:54 |
Publisher DOI: |
10.1016/j.jacc.2024.02.037 |
PubMed ID: |
38658108 |
Uncontrolled Keywords: |
hypertension malignant systemic |
BORIS DOI: |
10.48350/196226 |
URI: |
https://boris.unibe.ch/id/eprint/196226 |
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