Study note

Accelerated or malignant hypertension

THE CONTEXT

Accelerated hypertension is a rare complication of hypertension of any aetiology, characterised by rapidly progressive end-organ damage.

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Accelerated microvascular damage causes fibrinoid necrosis in the walls of small arteries and arterioles.

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Intravascular thrombosis is another characteristic feature.

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Diagnosis requires high blood pressure with rapidly progressive end-organ damage.

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Manifestations include grade 3 or 4 retinopathy, renal dysfunction—especially proteinuria—and hypertensive encephalopathy.

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Left ventricular failure may occur.

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Untreated disease causes death within months.

NEETx

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