On the central role of studies on the kidney in the recognition, conceptual evolution, and understanding of hypertension

Advances in Chronic Kidney Disease
Garabed Eknoyan

Abstract

Elevated arterial pressure had long been surmised from the strength of the pulse. Its association with contracted kidneys and hypertrophied hearts was described by Richard Bright (1789-1858). Microscopic observations of the narrowed and obliterated vasculature initially observed in the kidneys of Bright's disease, and subsequently throughout the body, launched clinical research into hypertension. The description of these findings in the absence of symptoms of kidney disease led to the recognition of primary hypertension. Ultimately, the systematic recording of the blood pressure with a pneumatic cuff and mercury manometer established the significance of hypertension as a distinct disease entity. Subsequent experimental studies established the central role of the kidney in hypertension through the renin-angiotensin system and extracellular volume control. This finding provided the basis for the introduction of diuretics and angiotensin converting enzyme inhibitors, two of the most important and valuable antihypertertensive drugs now available. Thus, the study of kidney disease and function has played a pivotal role in the conceptual evolution of the understanding of hypertension as a disease, the identification of its mechanisms...Continue Reading

References

Jan 1, 1975·Perspectives in Biology and Medicine·I H Page
Jan 1, 1980·Cardiovascular and Interventional Radiology·E C Martin, D H Gordon

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Citations

Sep 29, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Garabed EknoyanNorbert Lameire
Jul 9, 2004·Advances in Chronic Kidney Disease·Garabed Eknoyan
Jan 26, 2012·Journal of the Royal Society of Medicine·Vijay Sharma, Rubin Minhas

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