한국인 악성 고혈압의 임상적 고찰 = Clinical Study on Malignant Hypertension in Korea

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Objectives: Prior to the development of effective antihypertensive regimen and renal replacement therapy, malignant hypertension regarded as a bad prognostic disease. Sine 1960 with the early detection of hypertension and the introduction of new potent antihypertensive regimens and renal replacement therapy, there were several reports of etiologic changes and improving survival rates. However there has been a few reports concerning malignant hypertension in 1990s and never reported in Korea so far. The purpose of this study is to know the cause, clinical feature and survival rate of malignant hypertension in Korean, Method: The definition of malignant hypertension is characterized as grade III or IV hypertensive retinopathy according to Keith-Wagener-Barkers classification. we reviewed 107 patients with malignant hypertension who visited our department between 1988 and 1993 retrospectively. Results: The mean age of essential hypertension was 56years, renal lesion 37years, renovascular lesion 45years, and that of unknown cause was 41years, The mean blood pressure of essential hypertension was 209mmHg/128mmHg, renal lesion 194mmHg/120mmHg, renovascular lesion 210mmHg/130mmHg, and that of unknown cause was 183mmHg/125mmHg. The initial serum creatinine of essential hypertension was 2.45±2.51mg/dl, renal lesion 8.10±7.56mg/dl, renovascular lesion 1.95±0.35mg/dl, and that of unknown cause was 15.44±10.24mg/dl. Essential hypertension was diagnosed in 56 cases (53%), secondary hypertension in 40 cases (37%) and unknown cause in 11 cases(10%). The One year patient was 92% and 5 year survival survival 51%. The 5 year patient survival of essential hypertension was 85% and that of secondary hypertension was 86%. The 5year patient survival was 92% in the group of initial serum creatinine <3mg/dl, but 81% in the group of inital serum creatinine >3mg/dl. Ten patients died. Of these, three patients died of cerebrovascular accident, three patients died of hyperkalemia. Other causes of death were pulmonary edema, hepatic encephalopathy, lung cancer, and socioeconomic factor. Conclusion: the main cause of malignant hypertension in Korea was primary hypertension and survival rates were similar to recent other reports.