THE RENAL ORIGIN OF HYPERTENSION

Abstract
There is no reasonable doubt that some cases of human hypertension are of renal origin. The unsolved problem is whether many or most of those still referred to as "essential" are also of renal origin. The purpose of this review is to supplement the one made in 1940 by Blalock and to summarize and evaluate the pertinent evidence that has now accumulated for or against the renal origin of human essential hypertension. Only relatively recent original references are reviewed. Subtopics discussed are exptl. renal hypertension (temporary, due to constriction of one main renal artery, and persistent, due to constriction of both main renal arteries, and other measures); pathologic changes in the organs of animals with persistent hypertension; neurogenic and humoral mechanisms in the pathogenesis of exptl. renal hypertension; the properties and unitary measurement of renin, hypertensinogen, hyperten-sinase, hypertensin or angiotonin (and the similar pepsi-tensin); mechanism and site of formation or release of renin; treatment of exptl. renal hypertension by renal extracts and by antirenin; non-specific pressor and antipressor effects; and finally, in summary, a long list of similarities between human essential and exptl. renal hypertension.