Hyperpiesis: high blood-pressure without evident cause: essential hypertension.
The benign phase of hypertension offers a great contrast to the malignant phase, where for a given grade of elevated arterial pressure the authors have a much greater variability in duration of life and course of illness ; so much so that some patients live their full span and die of unrelated disease.
Abstract
The benign phase of hypertension offers a great contrast to the malignant phase. The course is long and variable, with the condition often remaining unchanged for years ; thus, of Bechgaard's original 1,038 patients, 357 were alive after 20 years (Bechgaard et al., 1956). Bechgaard (unpublished) has recently reported that 144 were alive after 26 to 32 years. Uraemia does not occur ; bilateral neuroretinopathy does not occur ; cerebral oedema does not occur, or occurs only rarely ; patients tend to die of heart failure, cerebral vascular disease, or intercurrent disease. Its nature is clearly different. The malignant phase is characterized by lesions which represent the limit of cardiovascular tolerance, fibrinoid arteriolar necrosis, retinal exudates representing focal vascular damage, hypertensive fits of similar origin, left ventricular failure in response to overloading. While each phenomenon is dependent also on other factors, thus accounting for some variation, few patients fail to exhibit at least two of these phenomena. In the benign phase the relationship between arterial pressure and the lesions that kill or cripple the patient seem to be less close ; factors other than arterial pressure intrude more. Hence for a given grade of elevated arterial pressure we have a much greater variability in duration of life and course of illness ; so much so that some patients live their full span1 and die of unrelated disease.