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In this issue of The Journal, p. 127, Smithwick, Porell, and Whitelaw discuss diagnostic features in 54 patients whose hypertension was due to lesions amenable to surgery of the kidney or adrenal gland. Such cases, which are relatively rare, constitute about 2% of the hypertensive population seen by these authors. The dramatic response of these patients to specific surgical treatment, however, emphasizes the importance of separating them from those with so-called essential hypertension.
Diagnosis is not always easy. Many of the authors' cases behaved very much like cases of essential hypertension. Some of them were clinically unsuspected, being discovered by routine exploration of renal and adrenal areas during bilateral lumbodorsal splanchnicectomy. What the authors have learned about diagnosis from these cases may be most helpful to all physicians currently treating the large number of patients with this disease. In the present era of drug therapy for hypertension, the diagnosis may
HYPERTENSION OF ADRENAL AND RENAL ORIGIN. JAMA. 1960;174(2):172. doi:10.1001/jama.1960.03030020060015