Jhetam D, Dansey R, Morar C, Milne F J
S Afr Med J. 1982 Jun 12;61(24):899-902.
During a 1-year period all Black patients admitted to two medical wards in the Johannesburg General Hospital were screened for malignant hypertension. Of the 62 patients eligible for inclusion in the study, 51 were thought to have essential malignant hypertension (hospital prevalence 2,2%). There was a striking absence of the cardiovascular and hypertensive risk factors usually described -- excessive smoking, alcohol consumption and obesity. The presenting features and complications were similar to those described in other series. Cardiac failure was present in 45% of the patients, neurological complications in 33%, and advanced renal failure in 47%. Twenty patients required dialysis. No evidence of ischaemic heart disease or atheromatous vascular disease was found. Red cell fragmentation was present in 25% of the patients. The hospital mortality rate was 25%. Only 24% of the patients had previously been diagnosed as having hypertension, although 43% had been examined by a doctor during the preceding 2 years. Of the patients discharged to the hypertension clinic, only 28% returned for short-term follow-up. Malignant hypertension is therefore a major medical and social problem in the Johannesburg Black community.
在一年时间里，对约翰内斯堡综合医院两个内科病房收治的所有黑人患者进行了恶性高血压筛查。在符合纳入研究条件的62例患者中，51例被认为患有原发性恶性高血压（医院患病率为2.2%）。通常所描述的心血管和高血压危险因素，如过度吸烟、饮酒和肥胖，在这些患者中明显缺乏。其临床表现和并发症与其他系列报道的相似。45%的患者出现心力衰竭，33%出现神经并发症，47%出现晚期肾衰竭。20例患者需要透析。未发现缺血性心脏病或动脉粥样硬化性血管疾病的证据。25%的患者出现红细胞碎片。医院死亡率为25%。尽管43%的患者在之前两年内曾接受医生检查，但只有24%的患者之前被诊断患有高血压。在转至高血压门诊的患者中，只有28%回来进行短期随访。因此，恶性高血压在约翰内斯堡黑人社区是一个主要的医疗和社会问题。
