HAMA Cohort
Malignant Hypertension

Main objectives

Malignant hypertension is one of the most severe form of hypertension. Its hallmark is a diffuse, subacute microvascular impairment leading to target organ damage as the heart, the kidney and the brain. Despite being severe and hurting young people, MHT is not well known by the medical community and its mechanism are poorly understood. We started in September 2019 the HAMA cohort to modernize the research in this field and the management of patients presenting malignant hypertension.


Patients with malignant hypertension, defined by severe hypertension (above 180/110 mmHg) and severe hypertensive retinopathy or diffuse microvascular target organ damage (at least 3 out of 4 conditions among heart, kidney, brain and endothelial damage).

You want to join the HAMA project ?

Please find HERE the proposal to start a project on the cohort. You may send the completed proposal to alice.seris@ch-pau.fr, or contact her to discuss your research project and/or to join the HAMA cohort.


Short and Long-Term Perspectives:

  • Launching the Adjudication Committee for Events : the aim is to verify adverse events reported in the database to ensure data reliability and enable future studies using this data.
  • Opening the HAMA database to all investigators who wish to work on the database.
  • Opening the cohort to European centers.
  • Launching the HAMA-COG project: Evaluation of the cognitive impact of malignant hypertension episodes based on brain involvement assessed by MRI.
  • Launching the HAMA Biobank: Collection of blood (plasma, DNA, RNA) and urine samples stored in a biobank to explore pathophysiological hypotheses explaining the transition from severe hypertension to malignant hypertension, search for risk and diagnostic biomarkers, and new therapeutic targets.
  • Recruiting a control cohort of patients with non-malignant severe hypertension. This assumes that these patients have undergone a comprehensive evaluation of target organs for malignant hypertension, and no organ meets the HAMA criteria

Our newsletters

Please find below the newsletters of the HAMA project:

To read previous newsletter

Contact Alice SERIS – Clinical Research Associate at CH de Pau – alice.seris@ch-pau.fr

Scientific council

  • Principal Investigator : Dr Romain Boulestreau (Pau / Bordeaux, France)
  • French scientific Council : Stephane Debeugny (Pau, France), Hervé Dreau (Pau, France), Alice Seris (Pau, France), Alexandre Persu (Louvain, Belgique), Jean Michel Halimi (Tours, France), Philippe Gosse, Mikael Mazighi, Benjamin Maier, Michel Pâques, Sophie Bonnin, Antoine Cremer, Sébastien Rubin (Bordeaux, France), Pierre-Louis Tharaux, Aurelien Lorthioir (Paris, France).
  • European member : Andrzej Januszewicz

Centres involved

30/03/2024 :
37 french centers (see the map below)
1 polish center: Warsaw

Recruitment, total and per centre

30/03/2024 :

Complete list of investigators in the HAMA research cohort updated as of 03/30/2024

Lien ici

  • The main objective of the cohort is to define the cardiovascular and renal prognosis at 5 years for patients presenting with malignant hypertension:
  • The project has numerous secondary objectives


Several substudies has already been funded:

30/03/2024 :

  • IVAMA (Ongoing, NCT04991077) :The pathophysiology of the transition from severe hypertension to malignant hypertension is poorly understood: why some patients never develop malignant hypertension despite repeated grade 3 hypertension, and others do ? The objective of this translational research project is to assess the relationship between the activation of vasoactive systems (renin-angiotensin and endothelin systems), the deficit in angiogenic signals (VEGF and sFlt-1), and the occurrence of episodes of malignant hypertension in humans.
    Funded by the FFC (IMPULSION Project, 30,000 euros)
    More details here: https://clinicaltrials.gov/ct2/show/NCT04991077?term=boulestreau&draw=2&rank=2
  • HAMA COG (currently launching): The objective is to assess the cognitive impact of malignant hypertension and to correlate patient’s cognitive socre to brain injuries visualized by brain MRI.
    Funded by the European Society of Hypertension (ESH Grant 30,000 euros)
  • HAMA Biobank (currently launching): The objective here is to collect biological samples (including plasma, RNA, DNA, and urine) from patients with malignant hypertension in acute and distant phases. The aim of this biobank will be to explore in detail the role of complement in MHT crisis, to extend the preliminary results of IVAMA, and to use omics approach to unravel diagnostic and risk biomarkers of malignant hypertension, and search for new therapeutic targets.
    Support from Alexion totaling 110,000 euros
  • Scientific Publications:
  • Conference Presentations Regarding the Cohort:
    • May 2024: Commented poster at the 2024 European Hypertension Congress on the initial results.
    • March 2024: 10th ESH pre-meeting, presentation of cohort perspectives
    • December 2023: Oral presentation at the 2023 French Hypertension Days: Characteristics at admission of the first 302 patients included in HAMA and comparison to historical cohorts.
    • December 2022: Poster presenting the rationale and design of the cohort

The French biobank will start soon !


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