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December 31, 1938

SURGICAL TREATMENT OF ESSENTIAL HYPERTENSION

JAMA. 1938;111(27):2492-2493. doi:10.1001/jama.1938.02790530046014
Abstract

The possibility of influencing chronic arterial hypertension by surgical intervention necessarily involves the study of mechanisms which in a precise and sensitive manner control and regulate the circulation. Variations in arterial pressure are influenced by the cardiac activity, its rate, the output, the circulating blood flow and the peripheral resistance or the vasomotor tone. These factors were believed to be under the direct central automatic regulation. The validity of this concept, however, was considerably impaired by the experiments of Pagano and Siciliano, who in 1900 demonstrated the existence of the carotid sinus mechanism by which the carotid blood pressure controls reflexly the general arterial pressure. By means of a special group of nerve fibers originating in the adventitia of the arteries of the carotid bifurcation, mainly in the carotid bulb and in the endothelial lining of the vessels of the carotid ganglion, this region is connected with the central nervous

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