Arteriolar Lesions in Hypertension : a Studyof 350 Consecutive Cases Treated

Abstract

Since 1933, approximately 900 cases of arterial hypertension have been submitted to supradiaphragmatic splanchnic-section and lower dorsal sympathetic ganglionectomy by M. M. Peet and his associates. Of these, 350 consecutive cases, which were followed for 1 to 7 years after the operation, have been reported on by Peet, Woods, and Braden (1). These authors pointed out that the selection of cases to be submitted to the operation is based on relatively simple requirements. Preferably, the patient should not be over 50 years of age; his renal function should be adequate, as indicated by a urea clearance of 'at least 40 per cent of normal and a power of concentrating urine above the specific gravity of 1.012 after 18 hours without food or liquids. The blood non-protein nitrogen should be below 45 mgm. per cent; the heart must be compensated. These clinical criteria are designed to determine whether the patient is capable of withstanding a major operative procedure; none of them has proved to be of significant prognostic value beyond the immediate outcome of the operation. A more direct investigation of the vascular system would probably give data of greater theoretical and practical value in the study of hypertension and, at the same time, might make it possible to differentiate reversible vascular lesions from lesions which have become permanent. Since the increased resistance of the arterioles has been recognized as the main mechanical factor in hypertension, a particular attempt should be made to differentiate between hypertension due to arteriolar spasm and hypertension due to thickening of the arteriolar wall. It is possible that an anatomical thickening of the arteriolar wall is not necessarily an irreversible phenomenon, since a moderate hypertrophy of the muscle fibers in the tunica media

Cite this paper

@inproceedings{FOA2013ArteriolarLI, title={Arteriolar Lesions in Hypertension : a Studyof 350 Consecutive Cases Treated}, author={P . FOA and NAOMI L . FOA and Max M. Peet}, year={2013} }