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THE PATHOGENESIS OF HYPERTENSION

JAMA. 1938;110(1):49-50. doi:10.1001/jama.1938.02790010051014.
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Until recently, the possible role of the kidney in the pathogenesis of hypertension had been the subject of much controversy. In 1932 Goldblatt and his collaborators published the first of a series of studies,1 since confirmed by others, showing conclusively that the kidney plays a special part in the production of high blood pressure.2

A century ago Richard Bright suspected a relation between pathologic changes in the kidney and vascular disease. He recognized that cardiac enlargement of extrinsic origin was frequently associated with renal disease. More recently, the arteriolar sclerosis frequently found in the kidney in hypertension was regarded as part of a process affecting the small blood vessels generally, but it was not considered of primary significance in the origin of hypertension. Some investigators, however, have insisted on a probable renal origin for hypertension, notably Fahr3 and Volhard,4 and numerous experiments5 have been performed

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