The Endocrine Aspects of Hypertension
It is generally accepted that an increase in blood pressure is merely a symptom and not a disease. The use of the diagnostic term, essential hypertension, is simply a compromise with our ignorance of the etiology of the condition, the outstanding symptom being used for its designation.
A number of clinical conditions have been shown to be associated with an increased intravascular tension. One group of cases of hypertension owe their genesis to primary parenchymatous, nonsuppurative renal changes, the group commonly designated as Bright's disease. The exact manner in which hypertension develops from renal change is still a matter of debate. Recent researches by Goldblatt1 would suggest that some interference with renal circulation produces a pressor substance which circulates in the blood stream and produces directly a contraction of the arterial musculature. Amyloid disease of the kidneys and suppurative diseases such as pyelonephritis, even apparently unilateral, may result in a marked increase in the blood pressure. The renal degeneration associated with the toxemia of late pregnancy may result in sudden and marked elevation of blood pressure. Hypertension may also be found in congenital polycystic disease and it often accompanies obstructions to the outflow of urine in such conditions as hypertrophy of the prostate gland. In these latter mechanical conditions, the onset of increased pressure may be sudden and, on relief of obstruction, it may subside as quickly as it occurred.
In the hypertension due to cardiovascular conditions, the increased pressure can apparently be explained on a purely mechanical basis. Here. . .