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April 25, 1980

Angiotensin and Hypertension

JAMA. 1980;243(16):1631. doi:10.1001/jama.1980.03300420015014

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To the Editor.—  I think the time has come when the cliché, "the mechanisms and cause of essential hypertension are unknown," can justifiably be altered to "it is highly probable that the core of the mechanism of essential, renovascular, and malignant hypertension is angiotensin." The evidence from blocking the converting enzyme and from peptide blocking agents all but conclusively shows that when angiotensin is unable to function, blood pressure returns to normal or near normal, especially if salt has been depleted.Furthermore, the evidence for a mosaic of regulatory mechanisms, internally equilibrated, also seems after some 30 years close to being accepted.There are many antihypertensive and pressor mechanisms, but the predominance of angiotensin as modulated by salt and perhaps a renal antihypertensive agent now almost surely should replace the avowal of ignorance.