Wednesday, July 11, 2018

Goldblatt hypertension

The pathophysiology of hypertension in renal artery stenosis (RAS) was first described by Goldblatt.

Ever since the original Goldblatt experiment in 1934, wherein experimental hypertension was produced by renal artery clamping, countless investigators and clinicians have been intrigued by the relationship between renal artery stenosis and hypertension.

In Goldblatt's early studies, hypertension in most animals lasted from 4 to 6 weeks and then blood pressures returned to normal levels, even though the clamps were still in place. An astute anatomical pathologist, Goldblatt noticed that the return to normal blood pressure was associated with conspicuous development of collateral arterial circulation to the kidney, particularly through the renal capsule.

In subsequent experiments he decapsulated the kidney and enclosed it in a membrane to prevent revascularization. When the renal artery of such animals was constricted, hypertension occurred and persisted.

In Goldblatt-I hypertension plasma renin activity is normal or low. The effect of 8-blocking agents equals the effect in Goldblatt-II hypertension, all values moving at a lower level in Goldblatt-I hypertension.
Goldblatt hypertension
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