THE NATURE OF ARTERIAL HYPERTENSION WITH SPECIAL REFERENCE TO THE RÔLE OF THE KIDNEY
Authors: Myron Prinzmetal, Ben Friedman, David I. Abramson
Journal: Annals of Internal Medicine (1939)

Article1 April 1939THE NATURE OF ARTERIAL HYPERTENSION WITH SPECIAL REFERENCE TO THE RÔLE OF THE KIDNEYMYRON PRINZMETAL, BEN FRIEDMAN, DAVID I. ABRAMSON, F.A.C.P.MYRON PRINZMETALSearch for more papers by this author, BEN FRIEDMANSearch for more papers by this author, DAVID I. ABRAMSON, F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-12-10-1604 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSince cardiac output,1 blood volume,2 and blood viscosity3 are normal in patients with hypertension, the only remaining factor that might produce the elevated blood pressure is an increased peripheral resistance. This increased resistance is presumably generalized throughout the systemic circulation, and is the result of vascular hypertonus4 confined to the arterioles although the small arteries may also be involved.5The generalized arteriolar hypertonus responsible for hypertension could theoretically be produced by increased sympathetic vasomotor impulses or by circulating substances having a direct or indirect constrictor action on the arterioles.Hypertension may be produced experimentally by means of renal ischemia,7ureteral...Bibliography1. LANTERBAUMAN SH(a) : Ueber den Kreislauf bei Hochdruck Arteriosklerose und Apoplexie, Ztschr. f. klin. Med., 1928, cix, 415. (b) BURWELL, C. S., and SMITH, W. C.: The output of the heart in patients with abnormal blood pressures, Jr. Clin. Invest., 1929, vii, 1. (c) WEISS, S., and ELLIS, L. B.: The quantitative aspects and dynamics of the circulatory mechanism in arterial hypertension, Am. Heart Jr., 1930, v, 448. (d) GLADSTONE, S. A.: Cardiac output and arterial hypertension, New York, The Author, 1935. Google Scholar2. LINDERLUNDSGAARDVAN SLYKESTILLMAN GCCDDS(a) : Changes in the volume of plasma and the absolute amount of plasma protein in nephritis, Jr. Exper. Med., 1924, xxxix, 921. (b) FREEMAN, N. E., and PAGE, I. H.: Hypertension produced by constriction of the renal artery in sympathectomized dogs, Am. Heart Jr., 1937, xiv, 405. CrossrefGoogle Scholar3. AUSTRIAN CR(a) : The viscosity of the blood in health and disease, Bull. Johns Hopkins Hosp., 1911, xxii, 9. (b) PICKERING, G. W.: The peripheral resistance in persistent arterial hypertension, Clin. Sci., 1936, ii, 209. (c) FRIEDMAN, B., and PRINZMETAL, M.: Vasomotor effects of blood in patients with hypertension, Proc. Soc. Exper. Biol. and Med., 1936, xliii, 543. Google Scholar4. PRINZMETALWILSON MC(a) : The nature of the peripheral resistance in arterial hypertension with special reference to the vasomotor system, Jr. Clin. Invest., 1936, xv, 63. (b) PICKERING, G. W.: See 3 (b). CrossrefGoogle Scholar5. ELLISWEISS LBS(a) : The measurement of capillary pressure under natural conditions and after arteriolar dilatation in normal subjects and in patients with arterial hypertension and with arteriosclerosis, Jr. Clin. Invest., 1929, viii, 47. (b) OPPENHEIMER, E. T., and PRINZMETAL, M.: Rôle of the arteries in the peripheral resistance of hypertension and related states, Arch. Int. Med., 1937, lx, 773. (c) STEELE, J. M.: Interpretation of arterial elasticity from measurements of pulse wave velocities, Am. Heart Jr., 1937, xiv, 452. CrossrefGoogle Scholar7. GOLDBLATTLYNCHHANZALSUMMERVILLE HJRFWW: Studies on experimental hypertension. The production of persistent elevation of systolic blood pressure by means of renal ischemia, Jr. Exper. Med., 1934, lix, 347. CrossrefGoogle Scholar8. HARTWICH A(a) : Der Blutdruck bei experimenteller Urämie und partieller Nierenausscheidung, Ztschr. f. d. gesammt. exper. Med., 1930, lxix, 462. (b) HARRISON, T. R., MASON, M. F., RESNICK, H., and RAINEY, J.: Changes in blood pressure in relation to experimental renal insufficiency, Trans. Assoc. Am. Phys., 1936, ci, 281. CrossrefGoogle Scholar9. PÄSSLERHEINEKE HD(a) : Versuche zur Pathologie des Morbus Brightii, Verhandl. d. deutsch. path. Gesellsch., 1905, ix, 99. (b) CHANUTIN, D., and FERRIS, E. B.: Experimental renal insufficiency produced by partial nephrectomy, Arch. Int. Med., 1932, xlix, 767. (c) RYTAND, D. A., and DOCK, W.: Experimental concentric and eccentric cardiac hypertrophy in rats, Arch. Int. Med., 1935, li, 511. Google Scholar10. ARNOTTKELLAR WMRJ: Hypertension associated with experimental oxalate nephritis, British Jr. Exper. Path., 1935, xvi, 265. Google Scholar11. MASUGI M(a) : Über das Wesen der spezifischen Veränderungen der Niere und der Leber durch das Nephrotoxin bzw. das Hepatotoxin, Beitr. path. Anat. u. allg. Path., 1933, xcii, 429. (b) SMADEL, J. E., and FARR, L. E.: Experimental nephritis in rats induced by injection of anti-kidney serum. Clinical and functional studies, Jr. Exper. Med., 1937, lxv, 527. Google Scholar12. HARTMANNBOLLIGERDOUB FWAHP(a) : Experimental nephritis produced by irradiation, Am. Jr. Med. Sci., 1929, clxxii, 487. (b) PAGE, I. H.: Relationship of extrinsic renal nerves to origin of experimental hypertension, Am. Jr. Physiol., 1935, cxii, 166. Google Scholar13. MOSLER E(a) : Über Blutdrucksteigerung nach doppelseitiger Nierenextirpation, Ztschr. f. klin. Med., 1912, lxxiv, 297. (b) CASH, J. R.: Further studies of arterial hypertension, Proc. Soc. Exper. Biol. and Med., 1926, xxiii, 609. (c) HARRISON, T. R., MASON, M. F., RESNICK, H., and RAINEY, J.: See 8 (b). Google Scholar14. PAGE IH(a) : See 12 (b). (b) COLLINS, D. A.: Hypertension from constriction of the arteries of denervated kidneys, Am. Jr. Physiol., 1936, cxiv, 616. Google Scholar15. GOLDBLATTGROSSHANZAL HJRF(a) : Studies on experimental hypertension. The effect of resection of splanchnic nerves on experimental renal hypertension, Jr. Exper. Med., 1937, lxv, 233. (b) FREEMAN, N. E., and PAGE, I. H.: See 2 (b). (c) BLALOCK, A., and LEVY, S. E.: Studies on the etiology of hypertension, Ann. Surg., 1937, cvi, 826. CrossrefGoogle Scholar16. BLALOCKLEVY ASE: See 15 (c). Google Scholar17. GLENNCHILDHEUER FCGGJ: Production of hypertension by constricting the artery of a single transplanted kidney, Ann. Surg., 1937, cvi, 848. CrossrefGoogle Scholar18. GOLDBLATT H: Studies on experimental hypertension. The pathogenesis of experimental hypertension due to renal ischemia, ANN. INT. MED., 1937, xi, 69. LinkGoogle Scholar19. TIGERSTEDTBERGMAN RG(a) : Niere und Kreislauf, Skand. Arch. f. Physiol., 1898, viii, 223. (b) BINGEL, A., and STRAUSS, E.: Über die blutdrucksteigernde Substanz der Niere, Deutsch. Arch. f. klin. Med., 1909, xcvi, 476. (c) VINCENT, S., and SHEEN, W.: The effect of intravascular injections of extracts of animal tissues, Jr. Physiol., 1903, xxix, 242. CrossrefGoogle Scholar20. SHAW HB(a) : Autointoxication: its relation to certain disturbances of blood pressure, Lancet, 1906, i, 1295, 1375, 1455. (b) HARTWICH, A.: Der Blutdruck bei experimenteller Urämie und partieller Nierenausscheidung, Ztschr. f. d. gesammt. exper. Med., 1930, lxix, 462. Google Scholar21. HARRISONBLALOCKMASON TRAMF: Effects on blood pressure of injection of kidney extracts of dogs with renal hypertension, Proc. Soc. Exper. Biol. and Med., 1936, xxxv, 38. CrossrefGoogle Scholar22. FISHBERG AM(a) : Anatomic findings in essential hypertension, Arch. Int. Med., 1925, xxxv, 650. (b) MORITZ, A. R., and OLDT, M. R.: Arteriolar sclerosis in hypertensive and non-hypertensive individuals, Am. Jr. Path., 1937, xiii, 679. CrossrefGoogle Scholar23. PRINZMETALWILSON MC: See 4 (a). PICKERING, G. W.: See 3 (b). Google Scholar24. BUTLER AM(a) : Chronic pyelonephritis and arterial hypertension, Jr. Clin. Invest., 1937, xvi, 889. (b) KERR, W. J.: Personal communication. (c) PRINZMETAL, M.: Unpublished observation. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication March 26, 1938.A preliminary report of this paper has appeared:PRINZMETAL, M., and FRIEDMAN, B.: Pressor effects of kidney extracts from patients and dogs with hypertension, Proc. Soc. Exper. Biol. and Med., 1936, xxxv, 122-124.†Work done during the tenure of Richard and Ella Hunt Sutro Fellowships.From the Medical Service of Dr. B. S. Oppenheimer and the Laboratory Division of The Mount Sinai Hospital, New York City.‡Hartwich20b ligated the renal artery and vein of one dog. The pressed juice of the necrotic kidney gave pressor effects but he was unable to determine whether or not this pressor effect was greater than that of the normal kidney of this animal or that of other kidneys of normal dogs. Hartwich did not measure the blood pressure of this animal but it is now known that ligation of the renal artery and vein is not followed by hypertension.18 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPhysiologie und Pathologie des Renin/Angiotensin-SystemsRenin und Hypertensin, physiologische oder pathologische Wirkstoffe?Herz und KreislaufKlinikThe Nature of the Pressor and Depressor Factors Derived from the KidneyThe action of angiotonin on the completely isolated mammalian heart 1 April 1939Volume 12, Issue 10Page: 1604-1616KeywordsArteriolesBlood pressureHypertensionKidneysMedical servicesRabbitsRenal arteriesRenal ischemiaResearch laboratoriesVeins ePublished: 1 December 2008 Issue Published: 1 April 1939 PDF downloadLoading ...