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June 1960

A Comparison of the Incidence of Bacteriuria Among Hypertensives and Matched Controls

AMA Arch Intern Med. 1960;105(6):899-904. doi:10.1001/archinte.1960.00270180077010

The role of chronic pyelonephritis in the causality of contracted kidney and uremia and its association with hypertension became widely appreciated with the appearance of the papers of Longcope1 and Weiss and Parker2 20 years ago. It has been assumed usually that the hypertension was secondary to the pyelonephritis rather than that the reverse relationship might be true. However, common as pyelonephritis is, hypertensive vascular disease is even commoner. The postulate that the hypertensive kidney might be more susceptible to pyelonephritis finds support in a number of experimental observations,3-5 but most strongly in that of De Navasquez6 who demonstrated that scarred kidneys were much more apt to become infected when exposed to a challenging bacteremia. As one of many possible approaches to the problem of comparing susceptibilities of hypertensive and nonhypertensive persons to pyelonephritis, a group of hypertensives was compared with a group of carefully matched controls for incidence of