Malignant hypertension in women of childbearing age and its relation to the contraceptive pill.
Open accessAbstract
Eleven of 34 women aged 15-44 with malignant phase hypertension were taking oral contraceptives at presentation. All had had normal blood pressure before starting to take the pill. In four the interval between the start of oral contraception and the diagnosis of malignant hypertension was less than four months, and in eight no other cause for the hypertension was found. Underlying renal disease and renal failure were less common among pill users than among non-users with malignant hypertension who were of similar age. No pill user became normotensive after withdrawal of the pill, but blood pressure was well controlled (diastolic less than 90 mm Hg) in three patients taking only one drug. By contrast, all 23 non-users needed two or more antihypertensive drugs to control blood pressure. Ten year survival was 90% among pill users and 50% among non-users. These results suggest that oral contraceptives may be a common cause of malignant hypertension in women of child-bearing age. If the pill is stopped and underlying renal disease excluded the long term prognosis for such patients is excellent.
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Cessation of estrogen use typically leads to a return to baseline blood pressure within 2 to 12 months, but proteinuria may persist.
“Cessation of estrogen use typically leads to a return to baseline BP within 2 to 12 months, but proteinuria may persist.209,210”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [210]
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Cites
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Carey, R. M., Calhoun, D. A., Bakris, G. L., Brook, R. D., Daugherty, S. L., Dennison-Himmelfarb, C. R., Egan, B. M., Flack, J. M., Gidding, S. S., Judd, E., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000084 · Cited by 1,153 · see citing works
- Authors
- Lim, K. G., Isles, C. G., Hodsman, G. P., Lever, A. F., & Robertson, J. W.
- Affiliations
- Western Infirmary (GB)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1987-04-25
- Volume
- 294
- Issue
- 6579
- Pages
- 1057-1059
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- OpenAlex
- W2049575463
- Cited by
- 48
- References
- 18
- Citations by year
- 2024: 1 · 2021: 1 · 2020: 2 · 2018: 3 · 2015: 1 · 2013: 2 · 2012: 1
- FWCI
- 0.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- malignant hypertension, oral contraceptives, women of reproductive age, drug-induced hypertension, antihypertensive therapy, survival, kidney disease, blood pressure control
- MeSH terms
- Adult, Blood Pressure, Contraceptives, Oral, Hormonal, Female, Humans, Hypertension, Malignant, Smoking
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