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Article
March 13, 1954

ADRENALECTOMY FOR SEVERE HYPERTENSIVE VASCULAR DISEASE

JAMA. 1954;154(11):914-916. doi:10.1001/jama.1954.02940450034012
Abstract

The role of the adrenal in human hypertension has not been clearly defined. That it plays a part in maintenance of normal blood pressure and may play a part in production of hypertension is suggested by some experimental and clinical evidence. Goldblatt found that total adrenalectomy interfered with experimental renal hypertension unless adequate supportive and substitution therapy was given. He assumed that the adrenal glands might play an accessory role. The primary mechanism of nephrogenic hypertension seems to be renal anoxia, with liberation of renin, interaction of renin and a substrate or activator, and formation of a pressor substance (named angiotonin by Page and hypertensin by Houssay). The depressor effect of adrenalectomy in the Goldblatt experiments probably resulted from development of a deficiency state that in turn caused alteration of the peripheral vascular resistance so that maintained increase of blood pressure could not occur.

Clinical evidence of a relationship between

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