BACKGROUND: To examine changing demography and survival of patients with malignant phase hypertension (MHT) over 40 years. METHODS: Patients from our MHT registry whose survival status on 31 December 2006 was known were included, with analyses conducted based on decade of MHT diagnosis. RESULTS: Four-hundred and forty-six patients with MHT (overall mean (s.d.) age 48.2 (12.9), years; 65.5% male; 64.7% white-European; 20.4% African Caribbean, and 14.8% South-Asian) were included. No significant demographic differences at diagnosis were evident over the 40 years, with the exception of a significant increase (P = 0.001) in the proportion of MHT among ethnic minorities (South-Asian and Afro-Caribbeans). There were no significant differences in mean systolic blood pressure (SBP) at presentation but baseline diastolic BP (DBP) was significantly lower after 1976 (P < 0.0001). The total number of person-years of observation was 5,725.5 years, with a median (interquartile range (IQR)) length of follow-up of 103.8 (31.3-251.2) months. Overall 203 patients (55.6%) died, 125 (32.0%) within 5 years of diagnosis. There was a significant improvement in 5-year survival from 32.0% prior to 1977 to 91.0% for patients diagnosed between 1997 and 2006. SBP and DBP improved significantly during follow-up (P < 0.0001). Multivariate analyses revealed that age, decade of MHT diagnosis, baseline creatinine, and follow-up SBP were independent predictors of survival (all P < 0.0001). CONCLUSIONS: Demography and number of new cases of MHT have not changed dramatically over the past 40 years. Five-year post-MHT survival has improved significantly, possibly related to lower BP targets, tighter BP control, and availability of new classes of antihypertensive drugs.
BACKGROUND: To examine changing demography and survival of patients with malignant phase hypertension (MHT) over 40 years. METHODS:Patients from our MHT registry whose survival status on 31 December 2006 was known were included, with analyses conducted based on decade of MHT diagnosis. RESULTS: Four-hundred and forty-six patients with MHT (overall mean (s.d.) age 48.2 (12.9), years; 65.5% male; 64.7% white-European; 20.4% African Caribbean, and 14.8% South-Asian) were included. No significant demographic differences at diagnosis were evident over the 40 years, with the exception of a significant increase (P = 0.001) in the proportion of MHT among ethnic minorities (South-Asian and Afro-Caribbeans). There were no significant differences in mean systolic blood pressure (SBP) at presentation but baseline diastolic BP (DBP) was significantly lower after 1976 (P < 0.0001). The total number of person-years of observation was 5,725.5 years, with a median (interquartile range (IQR)) length of follow-up of 103.8 (31.3-251.2) months. Overall 203 patients (55.6%) died, 125 (32.0%) within 5 years of diagnosis. There was a significant improvement in 5-year survival from 32.0% prior to 1977 to 91.0% for patients diagnosed between 1997 and 2006. SBP and DBP improved significantly during follow-up (P < 0.0001). Multivariate analyses revealed that age, decade of MHT diagnosis, baseline creatinine, and follow-up SBP were independent predictors of survival (all P < 0.0001). CONCLUSIONS: Demography and number of new cases of MHT have not changed dramatically over the past 40 years. Five-year post-MHT survival has improved significantly, possibly related to lower BP targets, tighter BP control, and availability of new classes of antihypertensive drugs.
Authors: Šárka Jíchová; Libor Kopkan; Zuzana Husková; Šárka Doleželová; Jan Neckář; Petr Kujal; Zdenka Vernerová; Herbert J Kramer; Janusz Sadowski; Elzbieta Kompanowska-Jezierska; Rami N Reddy; John R Falck; John D Imig; Luděk Červenka Journal: J Hypertens Date: 2016-10 Impact factor: 4.844
Authors: A Cremer; F Amraoui; G Y H Lip; E Morales; S Rubin; J Segura; B J Van den Born; P Gosse Journal: J Hum Hypertens Date: 2015-11-19 Impact factor: 3.012
Authors: Fouad Amraoui; Niels V Van Der Hoeven; Irene G M Van Valkengoed; Liffert Vogt; Bert-Jan H Van Den Born Journal: J Clin Hypertens (Greenwich) Date: 2013-12-27 Impact factor: 3.738
Authors: Jean Astrid Aka; Cyr Monlet Guei; Serge Didier Konan; Patrick Sery Diopoh; Syndou Sanogo; Hubert Kouamé Yao Journal: Pan Afr Med J Date: 2021-03-24