LAUSR

Objectives: Malignant hypertension (MHT) is defined as severe hypertension accompanied by ischemic failure of one or more organs. The aim of our study was to evaluate the clinical and etiological profile of MHT. Methods: The medical records of patients admitted to our center from January 2013 to August 2016 were reviewed. We consecutively selected 70 patients fulfilled the criteria for MHT, including (1) elevated DBP(DBP ≥ 120 mm Hg);and (2) presence of grade III or IV hypertensive retinopathy; and (3) with renal complications:increased creatinine, and/or proteinuria, hematuria. Datas of diagnostic, clinical manifestation and laboratory examination were analyzed. Results: The average age of them was 40 years, and more than half of subjects were males (78.57%). Among all patients with MHT, there were 24 cases with essential hypertension, accounting for 34.29%, and 46 cases with secondary hypertension, accounting for 65.71%. For secondary MHT, systemic vasculitis (25.57%) is the most common, followed by obstructive sleep apnea syndrome (OSAS)(15.71%), primary renal parenchymal hypertension (11.43%), primary aldosteronism (7.14%), and Cushing‘s syndrome (1.43%) and nutcracker phenomenon (1.43%). 20 patients with systemic vasculitis were characterized by severe hypertension accompanied by two or more target organs damage,of varying severity.The levels of white blood cells, hypersensitive c-reactive protein,serum creatinine and 24 hours urinary protein were above their normal range. Conclusion: Systemic vasculitis may be one of the main etiology of MHT, which has been underestimated in the past. In the future clinical work, Clinicians need to pay more attention to these patients with systemic vasculitis.