Management of Malignant Hypertension Complicated by Renal Insufficiency

Abstract

BEFORE the introduction of hypotensive drugs malignant hypertension uniformly resulted in early death. In 2 large series 79 per cent and 90 per cent of patients died in the first year after diagnosis.^{1 , 2} In contrast, a one-year survival rate of 85 per cent and a twelve-year survival rate of 38 per cent were recently reported in treated nonazotemic patients.³ There is general agreement that the main factor influencing length of survival is the state of renal function at the time of diagnosis. When this study was begun, the results from most published experience suggested that lowering of blood pressure in . . .