So-Called Malignant Hypertension

Recent work in America and abroad has emphasized the importance of a group of rapidly fatal cases associated with excessive hypertension. Among the various terms that have been employed to define this condition those most commonly used are malignant hypertension, malignant renal of Fahr, genuine contracted and chronic interstitial nephritis. The term malignant hypertension was first used by Volhard and Fahr 1 to designate cases of renal arteriosclerosis in which renal failure later developed. They assumed that the condition was caused by the addition of an inflammatory process to a kidney already damaged by arteriosclerosis, leading to infarction and necrosis of the glomerular loops. Fahr 2 later introduced the anatomic expression malignant renal sclerosis to designate changes in the kidney characterized by necrosis of the afferent glomerular arterioles and the capillary loops, with inflammatory changes in the corresponding glomerulus. Keith, Wagener and Kernohan 3 employed the term malignant hypertension in a