Abstract P539: Cardiac and Renal Involvement in Malignant-accelerated Hypertension: Implications on Long-term Survival

Abstract

Background: Malignant hypertension is a severe complication of arterial hypertension where end-organ damage is severe and occurs in a short period of time. Data about cardiac and renal involvement and implications on long-term survival of patients with malignant hypertension are scarce. Methods: We performed a single-centre retrospective analysis of 176 patients with malignant hypertension, diagnosed in the period 1984-2007. Results: Incidence of malignant hypertension decreased along the different periods of the study, but cardiac and renal damage at presentation were common and severe. In 94.6% we observed left ventricle hypertrophy on echocardiogram, in 83.2% the glomerular filtration rate was below 60 ml/min/1.73m2 and 11% of patients required immediate dialysis. The survival rate was 95% at 6 months, 90% at 12 months, 81% at 36 months, and 67% at 5-year follow-up. In a Cox-regression analysis, the independent predictors of all-cause mortality were age, SBP at discharge, septum wall thickness values and GFR at admission. Conclusion: Malignant hypertension remains a severe complication of arterial hypertension with a high mortality rate at 5-year, that was independently associated to the severe cardiac and renal involvement present in most patients.