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February 1988

Hypertension: A Neural Disease?

Author Affiliations

From the Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson.

Arch Neurol. 1988;45(2):178-179. doi:10.1001/archneur.1988.00520260064021

Early in my medical career I became completely convinced that either all or almost all essential hypertension was a neural disorder, more specifically a disease caused by continuous excessive discharge of the sympathetic nervous system. I developed this belief mainly because of a very fortunate experience: I worked as a surgical resident with Dr Reginald Smithwick,1 helping him to perform approximately 60 lumbodorsal sympathectomies for the treatment of essential hypertension. The initial effect of the sympathectomy was always an astounding fall in blood pressure, and the pressure remained low at least as long as the patients were still in the hospital.

Therefore, a few years later, my initial hypertension research studies were not for the purpose of determining the cause of hypertension—I already knew that—but, instead, were for the purpose of demonstrating experimentally the different neural mechanisms that can cause hypertension. Because it was my firm belief that

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