MALIGNANT HYPERTENSION IN YOUNG-WOMEN IS RELATED TO PREVIOUS HYPERTENSION IN PREGNANCY, NOT ORAL CONTRACEPTION

Previous studies have suggested that one-third of women of childbearin g age who develop malignant phase hypertension (MHT) are likely to be taking oral contraceptives (OC). We surveyed 104 women with a history of MHT. None of the 65 aged >45 years were taking OC or other sex horm ones. Thirty-nine (mean age 34.9 years, SD 8.0) were aged 15-44 years at presentation: 22 Caucasian, 10 Black/Afro-Caribbean and seven Indo- Asian. Of these 39, 22 had a history of hypertension in pregnancy (gro up 1), and 17 did not (group 2). Three of group 1 also had a history o f OC-induced hypertension. None were pregnant, but one was taking an O C at presentation with MHT. Blood pressures at presentation and follow -up, and mean serum urea and creatinine at presentation were similar b etween groups, as was median survival (96 vs. 47 months, Lee-Desu stat istic 0.75, p=0.38). There was a trend towards poorer renal function a t follow-up in group 1 patients, with higher mean serum urea and creat inine levels. The causes of death were renal failure (5), stroke (4) a nd heart disease (2). The OC was not a common cause of MHT amongst our sample of women of childbearing age, but a past history of hypertensi on in pregnancy was important. Such patients also had a longer duratio n of hypertension and poorer renal function at follow-up.