ReviewJournal of human hypertension2016
From malignant hypertension to hypertension-MOD: a modern definition for an old but still dangerous emergency.
Review in Journal of human hypertension, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.
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Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it, 130 citations in OpenAlex.
- ESC Council on hypertension position document on the management of hypertensive emergencies.European heart journal. Cardiovascular pharmacotherapy · 2019Guideline
- Long-term renal outcomes of patients with biopsy-proven malignant hypertension-associated renal thrombotic microangiopathy who are dialysis-independent at baseline.Renal failure · 2026Observational
- Article
- Hypertensive Emergency Presenting With Isolated Cranial Nerve III Palsy and Subsequent Intracranial Hemorrhage.Cureus · 2025Article
- Renal survival and improvement in younger malignant hypertension patients with thrombotic microangiopathy.Renal failure · 2025Article
- Brazilian Guidelines of Hypertension - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Clinicopathological Characteristics and Prognosis of IgA Nephropathy Combined With Malignant Hypertension Kidney Injury.Journal of clinical laboratory analysis · 2025Article
- Prediction of major outcomes in patients with malignant hypertension using machine learning: A report from the West Birmingham malignant hypertension registry.European journal of clinical investigation · 2025Article
- Potentially reversible severe cardiac involvement in thrombotic microangiopathies with malignant hypertension.Journal of nephrology · 2025Article
- Impact of Overweight on Renal Prognosis in Malignant Hypertension Patients With Thrombotic Microangiopathy.Journal of clinical laboratory analysis · 2024Article
- Role of aldosterone in various target organ damage in patients with hypertensive emergency: a cross-sectional study.BMC nephrology · 2024Article
- Serum Elabela expression is decreased in hypertensive patients and could be associated with the progression of hypertensive renal damage.European journal of medical research · 2024Article
- Malignant hypertension: current challenges, prevention strategies, and future perspectives.Frontiers in cardiovascular medicine · 2024Review
- Genetic, clinical, and pathological study of patients with severe hypertension-associated renal microangiopathy.Journal of nephrology · 2023Article
- Severe hypertension and (renal) thrombotic microangiopathy: solving the puzzle.Journal of nephrology · 2023Article
- Management of hypertensive crisis: British and Irish Hypertension Society Position document.Journal of human hypertension · 2023Review
- Prevalence of Myocardial Injury and Myocardial Infarction in Patients with a Hypertensive Emergency: A Systematic Review.Diagnostics (Basel, Switzerland) · 2022Review
- Cardiac Complications of Hypertensive Emergency: Classification, Diagnosis and Management Challenges.Journal of cardiovascular development and disease · 2022Review
- Review
- Malignant hypertension and atypical hemolytic uremic syndrome: a possible continuum between two entities?Journal of human hypertension · 2022Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The prevalence of malignant hypertension has clearly fallen with the advent of anti-hypertensive medication but has remained stable over the past 30-40 years in spite of progress in diagnosis and management of hypertension. A diagnosis of malignant hypertension is usually based on the association of severely elevated blood pressure with a Keith and Wagener stage III or IV retinopathy. We believe that this definition can be reconsidered for several reasons. Although simple and pragmatic, this definition corresponds to a time when there were few techniques for assessment of hypertensive target organ involvement, and does not take into account involvement of kidney, brain and heart; whereas the overall prognosis largely depends on how much they are affected. On the contrary, the acute blood pressure level and especially diastolic should not be a hard diagnostic criterion as it does not itself constitute the prognosis of the condition. We propose to consider that malignant hypertension with retinopathy is only one of a number of possible presentation(s) of acute hypertension with multi organ damage (hypertension multi organ damage (MOD)) and that the recognition of these hypertensive emergencies, when retinopathy is lacking, be based on acute elevation of BP associated with impairment of at least three different target organs. The objective of a new and expanded definition is to facilitate recognition of these true emergencies. The condition is more common than usually perceived and would have a much worse prognosis than the usual forms of hypertension. Early recognition and management of hypertension-MOD are fundamental to any improvement in prognosis.
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