Modern data concerning to clinic and pathogeneD sis of severe and malignant arterial hypertension

Abstract

Tо determine principal pathogenetic factors of therapy-resistant arterial hypertension (AH), 41 patients were examined: 1 male and 40 females aged 34-65 years, who suffered from malignant arterial hypertension (MAG). Control groups included 43patients (2 males and 341 females, aged 25-66 years) with Stage I-II AH by WHO-ISH classification (1999), as well as Stage III AH patients (N=45, 2 males and 43 females, aged 34-65 years). Intracardiac and central hemodynamics was assessed by echocardiography, renal function - by renoradiography, dynamic and static renoscintigraphy, and endogenous creatinine clearance. 24-hour extraction of cyclic nucleotides (cAMP and cGMP) was assessed by radioimmune method. Renal parenchimal disorders and vasorenal factors were the leading factors of MAH development. In MAH pathogenesis, various pathogenic factors - renal, vascular, endocrine, metabolic, and neurologic - were combined. All MAH patients demonstrated resistant hemodynamic type, with severe vasospastic reactions of eye vessels, and increased cGMP excretion, a symptom of reduced vasodilatator (NO) synthesis in vascular endothelium.

Keywords

• malignant arterial hypertension
• renal function
• differential diagnostics
• cyclic nucleotides