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Article
July 10, 1948

A CONCEPT OF PATHOGENESIS OF ESSENTIAL HYPERTENSION

JAMA. 1948;137(11):953-954. doi:10.1001/jama.1948.02890450033012
Abstract

Heinbecker1 presented evidence that a humoral mechanism rather than overfunction' of the sympathetic nervous system is the primary cause of essential hypertension. The concept is based on studies of the Cushing syndrome in man and the hypothalamicohypophysial relationships in the dog. The essential characteristics of the circulation in Cushing's syndrome are similar to those observed in essential hypertension. In both states diastolic hypertension and arteriolar sclerosis develop. Cushing in 1932 described a pluriglandular syndrome which, he believed, was always caused by a basophil adenoma. The syndrome, Heinbecker2 indicated, may be caused by an adrenal cortical tumor, by tumor of the ovary or a tumor of the thymus.

Crooke3 in 1935 described a histologic alteration in the basophil cells of the hypophysis in Cushing's syndrome which he characterized as degranulation or hyalinization. Heinbecker4

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