Systemic Vasculitis: An Important and Underestimated Cause of Malignant Hypertension

• Main Authors: Qing Zhu, MD, Shasha Liu, MD, Mulalibieke Heizhati, MD, Xiaoguang Yao, PhD, Menghui Wang, MD, Qin Luo, MD, Lei Wang, MD, Delian Zhang, PhD, Guijuan Chang, MD, Nanfang Li, PhD, MD
• Format: Article
• Language: English
• Published: Compuscript 2019-07-01
• Series: Cardiovascular Innovations and Applications
• Subjects: malignant hypertension; cause; systemic vasculitis
• Online Access: https://www.ingentaconnect.com/content/cscript/cvia/2019/00000004/00000002/art00002

Objectives: Malignant hypertension (MHT) is defined as severe hypertension accompanied by ischemic failure of one or more organs. The aims of this study were to evaluate the current clinical and etiologic profiles of MHT. Methods: As a retrospective study, we selected all patients admitted to our center from January 2013 to December 2016. Seventy patients with MHT were included. Results: The average age of the patients was 40 years, and more than half of the patients were male (78.57%). There were 24 patients with essential hypertension, accounting for 34.29% of the patients, and 46 with secondary hypertension, accounting for 65.71% of the patients. For secondary MHT, systemic vasculitis (25.57%) was the most common cause, followed by severe obstructive sleep apnea syndrome (15.71%), primary renal parenchymal hypertension (11.43%), primary aldosteronism (7.14%), and Cushing syndrome (1.43%) and nutcracker phenomenon (1.43%). Twenty patients with systemic vasculitis were characterized by severe hypertension accompanied by damage to two or more target organs of differing severity. The levels of white blood cells, hypersensitive C-reactive protein, serum creatinine, and 24-hour urinary protein were above their normal range. Conclusion: Systemic vasculitis may be one of the main causes of MHT, and has been underestimated in the past. In future clinical work, clinicians need to pay more attention to patients with systemic vasculitis.