Pathophysiology of malignant hypertension: a literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i9.32101

Keywords:

Malignant hypertension; Pathophysiology; Diagnosis.

Abstract

Malignant hypertension is a term that has been used to describe patients with high blood pressure (BP) and multiple complications (target organ damage) with a poor prognosis. Today, the term hypertensive crisis is used to describe patients who have severe BP elevations as follows: Systolic blood pressure (SBP) greater than 180 mmHg and diastolic blood pressure (DBP) greater than 120 mm Hg. The present study aims to analyze the pathophysiology of malignant hypertension. This is a study with a qualitative approach, where the integrative literature review was adopted, which according to Galvão (2012), is a construction of a broad analysis of the literature with pre-defined steps. Conducted through the Virtual Health Library (BVS) in Pubmed databases, using the crossings of the English descriptors “malignant hypertension”, “diagnosis”. Of the different types of hypertensive emergencies, malignant hypertension (MTH) is characterized by extreme elevations in BP and acute microvascular damage that affects various organs, in particular the retina, brain, and kidneys. HTM is likely to be underdiagnosed, being classified as a hypertensive emergency or unattended for several reasons. Malignant hypertension is a systemic disease that causes severe damage to the brain, heart, kidneys, and eyes. Blockers of the renin-angiotensin system appear to be the mainstay of treatment. Management of the clinical management of hypertension through consensus gained from clinical experience and evidence of inadequate quality is required.

References

Domek, M., Gumprecht, J., Lip, G. Y. H., & Shantsila, A. (2020) Malignant hypertension: does this still exist? J Hum Hypertens.34(1):1-4.

Galvão, C. M., et al. Revisão integrativa: método de revisão para sintetizar as evidências disponíveis na literatura. In: Brevidelli, M. M., Sertório, S. C. M. Trabalho de conclusão de curso: guia prático para docentes e alunos da área da saúde. 105-26, 2012.

Shantsila, A., & Lip, G. Y. H. (2019). Malignant hypertension: not quite an obsolete diagnosis yet. J Hypertens.37(2):282-283.

Naranjo, M., Chauhan, S., & Paul, M. (2022) Malignant Hypertension. In: StatPearls.

Charles, L., Triscott, J., & Dobbs, B. (2017) Secondary Hypertension: Discovering the Underlying Cause. Am Fam Physician. 96(7):453-461.

Rubin, S., Cremer, A., Boulestreau, R., Rigothier, C., Kuntz, S., & Gosse, P. (2019). Malignant hypertension: diagnosis, treatment and prognosis with experience from the Bordeaux cohort. J Hypertens. 37(2):316-324.

Otero-Marquez, O., Chung, H., Lee, C. S., Choi, E. Y., Ledesma-Gil, G., Alauddin, S., Lee, M., Bhuiyan, A., & Smith, R. T.(2021). Subretinal Deposits in Pre-eclampsia and Malignant Hypertension: Implications for Age-Related Macular Degeneration. Ophthalmol Retina. 5(8):750-760.

Bury. R,, Leon, R. J., Casteras, A., Vergara, A., Biagetti, B., García-Carro, C., Cordero-Vazquez, E., Hernández Hernández, I., Agraz, I., & Soler, M. J. (2021) Malignant hypertension and pheochromocytoma: a case report. Hipertens Riesgo Vasc.38(4):201-205.

Cavero, T., Arjona, E., Soto, K., Caravaca-Fontán, F., Rabasco, C., Bravo, L., de la Cerda, F., Martín, N., Blasco, M., Ávila, A., Huerta, A., Cabello, V., Jarque, A., Alcázar, C., Fulladosa, X., Carbayo, J., Anaya, S., Cobelo, C., Ramos, N., Iglesias, E., Baltar, J., Martínez-Gallardo, R., Pérez, L., Morales, E.,, González R., Macía, M., Draibe, J., Pallardó, L., Quintana, L. F., Espinosa, M., Barros, X., Pereira, F., Cao, M., Moreno, J. A., Rodríguez de Córdoba, S., & Praga, M. (2019). Severe and malignant hypertension are common in primary atypical hemolytic uremic syndrome. Kidney Int. 96(4):995-1004.

Boulestreau, R., Cremer, A., Lorthioir, A., Rubin, S., Tharaux, P. L., Persu, A., Halimi. J. M., & Gosse, P. (2019). Malignant hypertension: A bright future. Presse Med. 48(12):1439-1444.

Nattes, T., Saad, R., Buob, D., Verney, C., Doreille, A., Luque, Y., Mesnard, L., Pâques, M., & Rafat, C. (2021). Retinal Arteriolar Occlusions and Exudative Retinal Detachments in Malignant Hypertension: More Than Meets the Eye. Am J Hypertens. 18;34(1):30-33.

Gratiot, C., de Saint Sauveur, G., & De Faria, A. (2021). Siegrist streaks in malignant hypertension. J Fr Ophtalmol.44(8):1283-1285.

Singh, S. R., Handa, S., Dogra, M., & Dogra, M. R. Fundoscopy and malignant hypertension. QJM. 2019 Apr 1;112(4):305.

Lee, C. S., Choi, E. Y., Lee, M., Kim, H., & Chung, H. (2019). Descolamento seroso de retina na pré-eclâmpsia e hipertensão maligna. Eye (Londres, Inglaterra) , 33 (11), 1707-1714.

Boulestreau, R., van den Born, B. H., Lip, G., & Gupta, A. (2022). Hipertensão Maligna: Perspectivas e Desafios Atuais. Journal of the American Heart Association , 11 (7), e023397.

Grujić-Milanović, J., Jaćević, V., Miloradović, Z., Jovović, D., Milosavljević, I., Milanović, S. D., & Mihailović-Stanojević, N. (2021). O resveratrol protege o tecido cardíaco na hipertensão maligna experimental devido às propriedades antioxidantes, anti-inflamatórias e antiapoptóticas. Revista Internacional de Ciências Moleculares , 22 (9), 5006.

Poli, F., & Yusuf, I. H. (2021). Retinopathy in Malignant Hypertension. N Engl J Med.385(21):1994.

Ding, J., Qu, Z., & Yu, F. (2020). Um caso raro de hipertensão maligna com ruptura esplênica e microangiopatia trombótica: Relato de caso. Medicina , 99 (28), e20581.

Yong, B., & Power, D. A. (2018). Hipertensão Maligna Causando uma Síndrome Pulmonar-Renal. Relatos de casos em nefrologia , 2018 , 3273695.

Mrad, I. B., Fatma, L. B., Melek, B. M., Mami, I., Abdellatif, B. B., Miri, R., Zouaghi, S. M., & Denguir, R. (2021). Hipertensão maligna secundária à estenose da artéria ilíaca após transplante renal: relato de caso. The Pan African Medical Journal , 40 , 132.

Downloads

Published

17/07/2022

How to Cite

COSTA JÚNIOR, V. A. da; CAVALCANTI, A. L. M. .; NEGREIROS, F. da S. .; ROSA, Ícaro F. .; PORTELA, L. P. .; TEIXEIRA, L. N. A. . Pathophysiology of malignant hypertension: a literature review. Research, Society and Development, [S. l.], v. 11, n. 9, p. e52311932101, 2022. DOI: 10.33448/rsd-v11i9.32101. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/32101. Acesso em: 19 apr. 2024.

Issue

Vol. 11 No. 9

Section

Health Sciences

License

Copyright (c) 2022 Valmir Alves da Costa Júnior; André Luis Mendes Cavalcanti; Fernanda da Silva Negreiros; Ícaro Faustino Rosa; Letícia Pereira Portela; Luana Nascimento Alencar Teixeira

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.