- Email: [email protected]
Urologic hypertension. A study of 101 cases
SEIXCTED
511
ABSTRACTS
have size
made no new observation in this regard, but they have done well to emphait. The beneficial effects of sympathectomy on blood pressure cannot, apparently, be judged by the value of the blood pressure shortly after operation and many of those who have reported their results of sympathectomy for hypertension do not even include these values for blood pressure in their presentations. The proof of value of an operative procedure in influencing blood pressure depends on whether or not the blood pressure is persistently reduced when patients return to normal activity after operation. Study of the author’s data indicates that of the twenty-seven patients studied the blood pressure was siguificantly lower several years after operation than before in only seven instances. EWII of these late blood pressure determinations was malle when the patient returne~l to the hospital when congestive failure or other manifestations o~urrr~l, a time at whirh our might reasonably expect hlood pressure to be lolver as a result of rest and congestive failure. In evaluating the effects of any operations on arterial blood pressure it seems inadvisable to compare pressures during activity when patients Tyere in good enough phgsirxl contlition to warrant operation with those obtained later when they had congestive failure or other The authors hare performed a servicae hy emphasizing the need manifestations. for careful evaluation of results, but they have apparentlp committed th? same error which they attribute to those who have reported results of operat.ions on the sympathetic nervous system of patients with essential hypertension. ALLEN.
Maher, Proc.
C. C., and Wosika, P. II.: Inst.
Med.,
Chicago
Urologic
12: 388,
Hypertension.
A Study of 101 Cases,
1939.
In 660 hypertensive patients, the authors found that 101 exhibited a wide variety of urologic lesions. One quarter of these (26 cases) suffered from “parenchymal renal disease such as glomerulonephritis,” and the rest showed Hydronephrosis was common a variety of infectious and obstructive lesions. due to a variety of lesions. In the list of lesions were such conditions as pyelonephritis, renal stone, and even urethral stricture. The point made is that each case of essential hypertension deserves a thorough urological examination. STEELE.
Opsahl, Roald: On the Pathogenesis of Arterial Hypertension With Especial Regard to the Role of the Kidney and Adrenals in the Mechanism of White High Blood Pressure. Acta Med. Scandinav. Suppl. xcii. 1938, 262 pp. Part
I.
Physiological
Regulat.ion
of Arterial
Pressure
In the first few pages Opsahl records recent evidence for his premise that essential hypertension is due to a constriction of the peripheral arterioles not dependent upon nervous regulation but upon “intrinsic spasm” of the musculature. He defines the disease about which he wishes to talk (“Blutdruckkrankheit”) by indirection and says, “The concept can be delimited by excluding eonditions known to be or provisionally accepted as causes of hypertension. . . .” Tn this way he avoids the nosologic error of considering what is left as a single entity. Beginning with Allbutt’s break, in 1895, from the view of Traube that all hypertension was conditioned by renal disease, he briefly leads up to Volhard’s concept of ‘lred” and ((white” hypertension, and then states his own view in the form of a working hypothesis a.s follows: Persistent arterial hypertension
511
ABSTRACTS
have size
made no new observation in this regard, but they have done well to emphait. The beneficial effects of sympathectomy on blood pressure cannot, apparently, be judged by the value of the blood pressure shortly after operation and many of those who have reported their results of sympathectomy for hypertension do not even include these values for blood pressure in their presentations. The proof of value of an operative procedure in influencing blood pressure depends on whether or not the blood pressure is persistently reduced when patients return to normal activity after operation. Study of the author’s data indicates that of the twenty-seven patients studied the blood pressure was siguificantly lower several years after operation than before in only seven instances. EWII of these late blood pressure determinations was malle when the patient returne~l to the hospital when congestive failure or other manifestations o~urrr~l, a time at whirh our might reasonably expect hlood pressure to be lolver as a result of rest and congestive failure. In evaluating the effects of any operations on arterial blood pressure it seems inadvisable to compare pressures during activity when patients Tyere in good enough phgsirxl contlition to warrant operation with those obtained later when they had congestive failure or other The authors hare performed a servicae hy emphasizing the need manifestations. for careful evaluation of results, but they have apparentlp committed th? same error which they attribute to those who have reported results of operat.ions on the sympathetic nervous system of patients with essential hypertension. ALLEN.
Maher, Proc.
C. C., and Wosika, P. II.: Inst.
Med.,
Chicago
Urologic
12: 388,
Hypertension.
A Study of 101 Cases,
1939.
In 660 hypertensive patients, the authors found that 101 exhibited a wide variety of urologic lesions. One quarter of these (26 cases) suffered from “parenchymal renal disease such as glomerulonephritis,” and the rest showed Hydronephrosis was common a variety of infectious and obstructive lesions. due to a variety of lesions. In the list of lesions were such conditions as pyelonephritis, renal stone, and even urethral stricture. The point made is that each case of essential hypertension deserves a thorough urological examination. STEELE.
Opsahl, Roald: On the Pathogenesis of Arterial Hypertension With Especial Regard to the Role of the Kidney and Adrenals in the Mechanism of White High Blood Pressure. Acta Med. Scandinav. Suppl. xcii. 1938, 262 pp. Part
I.
Physiological
Regulat.ion
of Arterial
Pressure
In the first few pages Opsahl records recent evidence for his premise that essential hypertension is due to a constriction of the peripheral arterioles not dependent upon nervous regulation but upon “intrinsic spasm” of the musculature. He defines the disease about which he wishes to talk (“Blutdruckkrankheit”) by indirection and says, “The concept can be delimited by excluding eonditions known to be or provisionally accepted as causes of hypertension. . . .” Tn this way he avoids the nosologic error of considering what is left as a single entity. Beginning with Allbutt’s break, in 1895, from the view of Traube that all hypertension was conditioned by renal disease, he briefly leads up to Volhard’s concept of ‘lred” and ((white” hypertension, and then states his own view in the form of a working hypothesis a.s follows: Persistent arterial hypertension