Renal vascular diseases: Their relationship to hypertension

  • Peter J. Goldblatt
  • Amira F. Gohara
Part of the Developments in Nephrology book series (DINE, volume 8)


Since the initial observations of Richard Bright (1832) [1] an increasing body of knowledge has established a firm relationship between changes in the renal vasculature and the presence of systemic hypertension. The predominant view, which is essentially that expressed in the late 1800’s by Mahommad, [1] is that persistent hypertension through a mechanism which is as yet incompletely understood, causes widespread pathologic changes in the structure of arteries and arterioles. These include atherosclerosis of the major elastic vessels such as the aorta and its principal branches, and arterial and arteriolar sclerosis, in vessels throughout the body. With particular reference to the kidney, arterial and arteriolar sclerosis with scarring of the parenchyma (nephrosclerosis) of some degree is virtually always present in human cases of essential hypertension [2]. The well known experiments of Harry Goldblatt beginning in the early 1930’s [3] established that constriction of the main renal artery, even to a single kidney, resulted in systemic hypertension closely simulating essential hypertension in man. These experiments led him to postulate that the raised blood pressure was the result of changes in the renal vasculature, rather than the cause. Stemming from those investigations, a great deal of experimentation has established a humoral mechanism (renin-angiotensin-aldosterone, see Figures 1 and 2), which is acknowledged to play an important role in some types of hypertension.


Essential Hypertension Renovascular Hypertension Fibromuscular Dysplasia Malignant Hypertension Afferent Arteriole 
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Copyright information

© Martinus Nijhoff Publishing, Boston 1985

Authors and Affiliations

  • Peter J. Goldblatt
  • Amira F. Gohara

There are no affiliations available

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