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May 28, 1949

The Renal Origin of Hypertension

JAMA. 1949;140(4):437. doi:10.1001/jama.1949.02900390069029

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This monograph constitutes an excellent summary of recent results in the field of experimental renal hypertension and their application to the pathogenesis and treatment of human hypertension. Goldblatt reviews earlier and at best partially successful attempts at producing hypertension experimentally by various procedures applied to the kidney and then describes his classic work in producing chronic and malignant hypertension in dogs and other species by moderate and severe constriction of the renal arteries. He points out that in long-standing chronic experimental renal hypertension there is little arteriosclerosis and arteriolosclerosis but that the pathologic changes found in experimental malignant hypertension resemble those found in malignant hypertension in man. In discussing the pathogenesis of experimental renal hypertension, Goldblatt considers that a neurogenic mechanism is not involved but that the anterior pituitary and the adrenal cortex may possibly be concerned. He then discusses the renin-hypertensinogen-hypertensin-hypertensinase system and indicates that the origin of renin

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