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May 1974

Malignant Hypertension: Current Modes of Therapy

Author Affiliations

Durham, NC

From the Department of Medicine, Duke University Medical Center, Durham, NC.

Arch Intern Med. 1974;133(5):791-801. doi:10.1001/archinte.1974.00320170073006

The story of human hypertension research really begins in 1836 as a by-product of Richard Bright's1 investigations into the association of albuminuria and dropsy, which developed the broad concept of systemic vascular disease. In 1872, Gull and Sutton2 formulated the concept that a vascular disease, which they called "arterio-capillary fibrosis," was present as the "primary and essential condition in the morbid state called chronic Bright's disease with contracted kidneys." A new era in the study of hypertension began in 1879 with Frederick Horatio Akbar Mahomed's3,4 report on the first systematic investigation of blood pressure during life. He observed that elevation in blood pressure may either precede or follow renal disease, and he proposed the concept that "what is the cause in one case may be the result in another."

That hypertension may occur independent of renal disease and may pursue a variable course was reported by three

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