Abstract P182: Microangiopathic Complications In Malignant Hypertension: An Under-appreciated Form Of Target Organ Damage

Abstract

Fig 1: Summary of Malignant Hypertension Studies having Microangiopathic Complications along with Forest Plot Microangiopathic Complications in Malignant Hypertension: An underappreciated form of Target Organ Damage Background: Renal thrombotic microangiopathy is a clinically important complication of malignant hypertension (MHT), but its incidence in MHT has been sparsely studied. Our aim was to study the incidence of microangiopathic changes (MaC) in MHT. Methods: We searched Google Scholar database studies directly reporting MaC (mentioning either microangiopathic hemolytic anemia or thrombotic angiopathy) in presence of MHT. We used OpenMeta[Analyst] for the pooled analysis. Results: From 1967 to 2019, 9 studies were included. Maximum likelihood random-effects method showed pooled proportion estimate of having MaC in MHT to be 0.4 (95 CI: 0.3, 0.5; p<0.1). Significant heterogeneity with I 2 =82.56%, p <0.1 was found. Subgroup analysis showed pooled proportion of MaC in MHT to be 0.5 (95 CI: 0.4,0.7, p<0.1) for studies before 2000; whereas 0.2 (95 CI: 0.2, 0.3, p<0.1) for studies after 2000. Sex-wise distribution was reported in 7 studies, risk ratio of having MaC in MHT in female was found to be 1.24 compared to male. Conclusion: Our analysis suggests decreasing incidence of MaC in MHT over the past couple of decades and increased risk of this complication in females, although significant heterogeneity exists among studies reporting microangiopathic changes in malignant hypertension. More prospective observational studies are needed to better define the epidemiology of the hematological changes that occur in MHT since they have important therapeutic implications.