ARTERIAL HYPERTENSION

Abstract

Increased arterial pressure of known or suspected causation occurs in at least forty-seven syndromes, which, according to pathogenesis, are grouped as neurogenic, endocrine, cardiovascular and renal.¹ However, as a problem in clinical practice, hypertension is largely limited to those syndromes called essential and malignant hypertension. The genesis of these states, which had been regarded as renal since the time of Bright, has remained obscure since their separation from glomerulonephritis in the works of Allbutt, Janeway, Volhard, Keith and others. The demonstration by Goldblatt² that lasting hypertension occurs after partial compression of one or both main renal arteries by a metal clamp revived interest in the relationship of the kidneys to increased arterial pressure. Experimental hypertension of similar nature was subsequently induced by one of us,³ who produced fibrocollagenous perinephritis by application of silk or cellophane to the kidneys. Compression of the renal parenchyma in the scar resulted