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April 17, 1943

Current Comment

JAMA. 1943;121(16):1286-1287. doi:10.1001/jama.1943.02840160036012

RENAL VASCULAR DISEASE AND HYPERTENSION  The demonstration by Goldblatt1 that chronic hypertension regularly follows partial clamping of the renal arteries of dogs and by Moritz and Oldt2 that people with chronic hypertension usually show diffuse renal arteriolar sclerosis at necropsy, whereas normal persons rarely have such sclerosis, suggests that renal vascular disease in man may be the etiologic counterpart of the Goldblatt clamps in the dog. Although it has been recognized that degenerative vascular disease often follows the appearance of hypertension, the new evidence lends support to the view that renal vascular disease may often be primary and causal. A recent study of renal biopsies from 100 human subjects incident to the performance of splanchnic resections for hypertension afforded Castleman and Smithwick a unique opportunity to investigate an earlier stage of the disease than had been theretofore studied. Although all their patients had severe chronic hypertension, the renal