The Hypertensive Vascular Crisis

The Hypertensive Vascular Crisis: An Experimental Study focuses on the crisis in man and of the hypertension from which it originates and the development of an experimental model and its use to obtain information to suggest a working hypothesis.

The publication first offers information on the clinical problem and experimental evidence. Discussions focus on hypertension, essential and malignant hypertension, vicious circle in chronic hypertension, effect of pregnancy on experimental hypertension, and reversibility of chronic hypertension. The text then examines the hypothesis tested, including changes in vascular caliber re-examined, possible effects of the changes in caliber, structural lesions re-examined, focal edema re-examined, and thesis restated.

The manuscript elaborates on technique, as well as anesthesia, resuscitation, blood pressure, apparatus, measuring systolic blood pressure, and cranial windows.

The publication is a dependable source of information for readers interested in hypertensive vascular crisis.

Preface

Part 1 The Clinical Problem

Introduction

The Hypertension

Hypertension and the Kidney

Essential Hypertension

Renal Hypertension

Malignant Hypertension

The vascular Crisis

The Symptoms of the Crisis

The Cause of the Symptoms

Part II The Experimental Evidence

Goldblatt's Experiment

Unilateral Renal Hypertension in the Rat

Changes in the 'Clipped' Kidney

Changes in the Untouched Opposite Kidney

The Vicious Circle in Chronic Hypertension

The Effect of Pregnancy on Experimental Hypertension

The Reversibility of Chronic Hypertension

The Vascular Crisis in Experimental Hypertension

The 'Clinical' Picture

The Effect of Treatment

Aggravating Factors

The Pathogenesis of the Crisis

Structural Lesions

Cerebral Edema

The Nature and Distribution of the Cerebral Edema

Edema in Other Tissues

The Caliber of the Cerebral Arteries

The Working Hypothesis Stated

Part III The Hypothesis Tested

The Changes in Vascular Caliber Re-Examined

The Intestinal Arteries

The Retinal Arterioles

The Cerebral Arteries Re-Examined

The Cause of the Changes in Arterial Caliber

The Possible Effect of the Changes in Caliber

Excessive Dilatation

Excessive Constriction

The Structural Lesions Re-Examined

The Causation of Arterial Necrosis

Are the Lesions Caused by the Hypertension?

'Atypical' Arterial Necrosis

Causes of 'Atypical' Arterial Necrosis

The Significance of 'Atypical' Arterial Necrosis

'Atypical' Arterial Necrosis in Cerebral Crises

'Atypical' Arterial Necrosis in Early Goldblatt Hypertension

How Does Hypertension Cause Arterial Necrosis?

Excessive Constriction

Excessive Dilatation

The Vulnerability of Weakened Arteries

The Protective Effect of Medial Hypertrophy

The 'Sensitizing' Effect of X Irradiation

Extrusion of Plasma

Giese's Experiments

Are Other Factors Concerned in Causing Necrosis?

Uremia

'Spontaneous' Vascular Disease

Enzyme Factors

Vasculo-Toxic and 'Permeability' Factors

Contents

Summary

The Causation of Associated Lesions

Endarteritis fibrosa

Capillary Glomerular Aneurysms and Focal Necroses

The Effects of Hypertensive Arterial Lesions

The Focal Edema Re-Examined

The Cause of Focal Edema

Is High Pressure the Cause of the Edema ?

How does High Pressure Cause the Edema ?

Are Other Factors Concerned?

'Permeability' Factors

Permeability Factors in Renal Extracts

Ligature of Renal Arteries

Ligature of Ureters

Constriction of Renal Arteries

Saline Loading

Renin and the 'Permeability' Factor

'Permeability' Changes in Unilateral Renal Hypertension

High Blood Pressure as the 'Permeability' Factor

The Effects of Hypertensive Focal Edema

The Weaknesses of the Working Hypothesis

The Thesis Restated

Conclusion