Abstract
Malignant hypertension (MHT) is a rare and severe form of hypertension characterised by arteriolar necrosis and severe vascular damage, leading to stroke, myocardial infarction and death. We hypothesised that in addition to endothelial damage, MHT may be associated with increased oxidative stress. Lipid hydroperoxides (LHP, an index of oxidative damage) and plasma von Willebrand factor (vWf, an index of endothelial damage/dysfunction) were measured in 16 patients with MHT and compared with 16 non-malignant essential hypertensives and 32 normotensive controls. vWf was greater in MHT (mean 117 iU/dL) than in non-malignant hypertensives (97 iU/dL) or normotensive controls (100 iU/dL) (ANOVA P = 0.017). However, although LHP were greater in MHT (mean 10.6 μmol/L) than in normotensives (4.5 μmol/L, P < 0.001), the levels in MHT were similar to those in non-malignant hypertension (12.3 μmol/L). In conclusion endothelial damage (raised vWf) was more evident in MHT compared with both normotensive controls and with non-malignant hypertension, whilst oxidative stress (raised LHP) was increased to a similar extent in both hypertension groups when compared with normotensive controls. These observations raise the possibility abnormal oxidative stress is probably not the mechanism responsible for the endothelial damage seen in malignant phase hypertension.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 digital issues and online access to articles
$119.00 per year
only $9.92 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Keith NM, Wagener HP, Barker NW . Some different types of essential hypertension, their course and prognosis Am J Med Sci 1939; 196: 332–343
Leishman AWD . Hypertension-treated and untreated: a study of 400 cases Br Med J 1959; 1: 1361–1363
Lip GYH, Beevers M, Beevers DG . Complications and survival of 315patients with malignant-phase hypertension J Hypertens 1995; 13: 915–924
Lip GYH, Beevers M, Beevers DG . The failure of malignant hypertension to decline: a survey of 24 years’ experience J Hypertens 1994; 12: 1297–1305
Ahmed MEK, Walker JM, Beevers DG, Beevers M . Lack of difference between malignant and accelerated hypertension Br Med J 1986; 292: 235–237
Nourooz-Zadeh J, Tajaddinni-Sarmadi F, Wolff SP . Measurement of plasma hydroperoxide concentrations by the ferrous oxidation-xylenol orange assay in conjunction with triphenylphospine Ann Biochem 1994; 220: 403–409
Blann AD, Lip GYH . The endothelium in atherothrombotic disease: Assessment of function, mechanisms and clinical implications Blood Coagulation Fibrinolysis 1998; 9: 297–306
Lee AJ . The role of rheology and haemostatic factors in hypertension J Hum Hypertens 1997; 11: 767–776
Lip GYH, Blann AD, Beevers DG . Prothrombotic factors, endothelial function and left ventricular hypertrophy in isolated systolic hypertension compared with systolic-diastolic hypertension J Hypertens 1999; 17: 1203–1207
Lip GYH, Blann AD, Jones AF, Lip PL, Beevers DG . Relation of endothelium, thrombogenesis and haemorheology in systemic hypertension to ethnicity and left ventricular hypertrophy Am J Cardiol 1997; 80: 1566–1571
Nuttall SL, Cox G, Kendall MJ, Martin U, Temple RM . Vitamin supplementation reduces oxidative stress inpatients with conservatively managed chronic renal failure J Am Soc Nephrol 1999; 10: 83A
Acknowledgements
We acknowledge the support of the City Hospital NHS Trust Research and Development programme for the Haemostasis Thrombosis and Vascular Biology Unit.
Author information
Authors and Affiliations
Corresponding author
Additional information
This paper was submitted to, and dealt with by, the USA Editorial Office of the Journal of Human Hypertension.
Rights and permissions
About this article
Cite this article
Lip, G., Edmunds, E., Nuttall, S. et al. Oxidative stress in malignant and non-malignant phase hypertension. J Hum Hypertens 16, 333–336 (2002). https://doi.org/10.1038/sj.jhh.1001386
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jhh.1001386
Keywords
This article is cited by
-
The impact of propranolol on nitric oxide and total antioxidant capacity in patients with resistant hypertension—evidence from the APPROPRIATE trial
BMC Research Notes (2020)
-
Hypertensive crisis in children and adolescents
Pediatric Nephrology (2019)
-
Sex differences in the blood antioxidant defense system in juvenile rats with various genetic predispositions to hypertension
Hypertension Research (2016)
-
Impaired endogenous fibrinolytic capacity in prehypertensive men
Journal of Human Hypertension (2015)
-
Potential approaches to reverse or repair renal fibrosis
Nature Reviews Nephrology (2014)