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ACCELERATED HYPERTENSION AND ANAEMIA
OP Kapoor
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
Sometime back, I read in a medical journal that ‘Accelerated’ hypertension can cause mild anaemia in the same way as a prosthetic valve implanted in the heart. Initially, I did not believe this. In practice, I see a lot of patients of ‘Accelerated hypertension’. Many of them are males and for no apparent cause, develop very high levels of blood pressure inspite of continued medication.
If they are elderly, I ask for renal doppler and Isotope Renal Scan studies to rule out atheroma of renal arteries which might produce secondary hypertension. Most of the time, these studies are normal. I would then explain to the patient that this is a temporary phase where you will need an additional drug and after some time (the duration of which I cannot guess) they will return to the original maintenance dose.
In the past, I have never scrutinised the Hb levels very closely. In most male patients, the Hb must be around 13-14 gm or more. Lately, I have been observing such patients and comparing their Hb levels to the previous levels which were recorded in the patient’s file. In the last six months, I found three patients whose Hb used to be more than 14 gm in whom the Hb was 12 gm at the time of ‘Accelerated hypertension’ which was passed on by me as ‘normal’. In retrospect, I feel that these patients had ‘mild anaemia with Accelerated hypertension’, which is a definite entity.
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