Gyh. Lip et al., MALIGNANT HYPERTENSION IN YOUNG-WOMEN IS RELATED TO PREVIOUS HYPERTENSION IN PREGNANCY, NOT ORAL CONTRACEPTION, Quarterly Journal of Medicine, 90(9), 1997, pp. 571-575
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.