MALIGNANT HYPERTENSION HAMA COHORT: WHERE DO WE STAND IN 2021?

Abstract

Objective: Malignant hypertension still exists. It is the deadliest form of hypertension, and has been forgotten. Guidelines are mainly based on consensus, without strong evidence supporting it. French cohort HAMA is the first multicentric nationwide Describe the characteristics of the 300 first patients included in the HAMA cohort, the substudies started and in preparation and the perspectives. Design and method: We set up a prospective, multicentre, observational cohort of patients with malignant hypertension. We collected at admission medical history, demographic data, ongoing treatment, clinical parameters, symptoms, care pathways, target organ status and at discharge and during follow up treatment administrated, adverse events, blood pressure level, target organ status. We aim to recruit 500 patients with malignant hypertension crisis in 5 years, with a 5-year follow-up. Our primary objective is to assess the 5 years prognosis of these patients. Results: We included 245 patients between September of 2019 and November of 2021, mainly men (66%), mean age 51,4 +/- 13,3 years, BMI 28 +/- 5,7, systolic and diastolic blood pressure at admission 228 +/- 23 and 124 +/- 25. Target organs damage included severe hypetensive retinopathy (87%), cardiac damage (52%), acute kidney injury (62%), cerebral damage (34%), thrombotic microangiopathy (15%). Conclusions: The findings of this cohort should help increasing the medical community awareness and disease screening. It should provide an up-to-date picture of the epidemiology of the disease, and help physician building guidelines based on high quality evidence, to improve the management of patients with malignant hypertension crisis. Subsequently, the knowledge gained from the HAMA cohort may be used to design controlled intervention and pathophysiological studies through biobank implementation. Next big step ahead is the inclusion of european centers.