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- W4315779166 abstract "A 37-year-old man with no past history of hypertension presented with no symptoms but with acutely elevated blood pressure (230/140mmHg) and proteinuria (> 300 mg/dL). Fundoscopic appearance represented grade IV hypertensive retinopathy with papilledema, flamed-shaped hemorrhages, exudates and arteriovenous nipping, indicating typical features of the malignant hypertension. The laboratory tests at admission indicated the possible organ damages in kidney and heart (eGFR 21 mL/min/1.73m2, BNP 263pg/mL). The other examinations are normal. After 20 days of treatments with amlodipine, azilsartan and carvedilol, the average of multiple blood pressure measurements and BNP showed almost normal levels (146/87mmHg, BNP < 10pg/mL), although eGFR level was still under 30. In addition, at this time point, flow mediated dilation (FMD), a noninvasive index of vascular endothelial function measured in forearm, showed significant impairment of endothelial function (%FMD 2.6). At 60 days, fundoscopic images represented entire restoration of retinopathy with disappearance of papilledema, hemorrhage and exudates. In contrast, however, both endothelial and renal function were still under normal levels (%FMD 3.2, eGFR 28.2 mL/min/1.73m2). Notably, FMD showed improvement of sustained endothelial dysfunction at day 90 (% FMD 7.5), while a little recovery of renal function was observed at 360 days (eGFR 35.4 mL/min/1.73m2). This case represents the possibility that damaged endothelial and renal function in acute severe hypertension seem to be still reversal with appropriate anti-hypertensive treatment, while differential time-course recovery in each organ might be existed." @default.
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- W4315779166 date "2023-01-01" @default.
- W4315779166 modified "2023-10-04" @default.
- W4315779166 title "PS-R04-8: DIFFERENTIAL RECOVERY OF IMPAIRED ENDOTHELIAL AND RENAL FUNCTION IN A CASE OF MALIGNANT HYPERTENSION" @default.
- W4315779166 doi "https://doi.org/10.1097/01.hjh.0000917364.56852.c2" @default.
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