Hypertension Grand Rounds Severe Hypertension

Small-vessel arteritis is associated with hypertension be-cause the commonest varieties, granulomatous vasculitis with polyangitis and microscopic polyangitis with antineutro-phil cytoplasmic autoantibodies, usually cause necrotizing glomerular disease. Medium vessel vasculitis, such as pol-yarteritis nodosa and Kawasaki disease, are less regularly associated with hypertension. Large-vessel vasculitis, such as giant cell arteritis, commonly coincides with hypertension. Takayasu arteritis, a granulomatous inflammation of the aorta and its major branches, generally afflicts patients aged younger than 50 years. Mikito Takayasu1 first described the condition in a woman reporting visual loss. Takayasu found abnormal anastomoses on funduscopic examination termed “coronary anastomosis ” of the retinal vasculature because of the corona-like vessel connections. Katsutomo and Tsuruki-chi described similar young female patients and made th