Renovascular And Renal Parenchymatous Hypertension

This monograph provides a timely update on the pathophysiology, diagnosis, and therapy of renovascular and renal parenchymatous hypertension. The underlying causes of the most common forms of hypertension are discussed in separate chapters. Special emphasis is laid on newer pathophysiological aspects of the disease, in particular the vascular wall renin-angiotensin system. Furthermore, there is in depth discussion of all the new techniques that are currently available for use in the diagnosis of renal hypertension, e.g., ultrasound and Doppler techniques, magnetic resonance imaging, and nuclear renography. These techniques are discussed by internationally renowned experts in the field. The book also covers topics such as the value of medical therapy, surgical techniques, and percutaneous transluminal angioplasty, with special reference to the treatment of renal hypertension.

"Where are all these kidney patients coming from? A few perfection the study of the urinary sediment, clinically years ago we had never heard of kidney disease and now practical kidney function tests, and the natural history of a number of kidney diseases including glomerulonephritis. you are speaking of patients in the hundreds of thousands and indeed potentially millions. " My reply, not meant to William Goldring, Herbert Chasis, Dana Atchley, and others studied the effects of hypertension, endocarditis, be grim, was "From the cemetery, Sir. " This is a summary and circulatory diseases on the kidney and spawned suc of some Congressional testimony lance gave on behalf of extending kidney disease under Medicare. Where indeed cessive generations of alert clinical investigators, who be gan to chronicle the natural histories of a wide variety of were all the patients with kidney disease in the United States before World War II? They were certainly not kidney diseases. Quantitative studies of renal function flourished under a school headed by Homer Smith, and under the care of nephrologists! Nephrology was not listed in the questionnaires for any state or the American Medi surprisingly precise techniques were developed for study ing a whole range of explicit nephron functions. Imagine cal Association as a subspecialty or even as a special the joy with the advent of vascular catheterization to be interest.

Blood pressure control is central to all bodily functions. There are many points in the multifaceted cybernetic system wherein hypertension may be produced. Hypertension is a 'young' disorder whose existence has been known for less than a century. It is not only extremely prevalent among every popula tion, but also deleterious to the health of mankind. The more we understand about hypertension's harmful effects, the more urgent is the need for its effective control. The kidney is the central organ that controls vascular tone and body fluid volume; these two factors are dominant in determining arterial blood pres sure. Hence, it is not surprising to find in hypertensive disorders that there are abnormalities in the kidneys, functional or anatomical, subtle or overt, that cause or are the consequence of hypertension. The first suggestion that the kidney could cause hypertension was made in 1836, before arterial pressure could even be measured, by Richard Bright. He observed that cardiac hypertrophy was often present in patients who died of renal disease. It was, however, Goldblatt and his colleagues in 1934 who opened the modern era of experimental and clinical research in renal hypertension. Since then, although far from complete, enthusiastic and intensive research efforts have greatly improved our understanding of the nature of renal hypertension.

Hypertension is a major world-wide health problem. With high blood pressure there is a greater risk of stroke, heart attack, heart failure, kidney disease and renal failure. Far too few people realize what the risks are and what can be done to prevent these risks even in the countries where pro grams in hypertension research are active and the full significance of hyper tension is best understood. Some studies of the known hypertensive popu lation indicate that one-half or less are receiving adequate treatment, and, of those on therapy, only half have their high blood pressure satisfactorily controlled. These realizations emphasize the need to inform all segments of society throughout the world on the importance of detection and control of high blood pressure. The great incidence of hypertension makes it of para mount importance that all practicing physicians have available the latest information on diagnosis and treatment of hypertensive cardiovascular dis ease. This treatise on hypertension arrives at a time when there is an increasing recognition the world over of the importance of detecting and treating high blood pressure. The book has been edited by Dr. A. Amery and his asso ciates in the University of Leuven. Professor Amery is one of the leaders in the field of hypertension and serves on the Council of the International Society of Hypertension.

During the last few years, renal hypertension has become a subject of increasing importance. The development of improved radiological techniques, notably intravenous and intra-arterial digital subtraction angiography, has made the diagnosis of renal artery stenosis more reliable, while advances in vascular surgery and the introduction of percutaneous trans luminal angioplasty have caused major changes in clinical practice. The increasing use of such potent antihypertensive agents as the angiotensin I converting enzyme inhibitors has empha sized the problem of renal artery stenosis in older patients with wide spread vascular disease as well as improving the prognosis of patients with accelerated hypertension. This book examines the surgical and medical aspects of renal hyper tension in the light of these recent advances. Each chapter has been written by a recognized expert in the field and provides information of relevance and practical importance to the average clinician. The developments of the last decade have emphasized that renal hyper tension is no longer a matter only for the nephrologist but a subject on which all clinicians should be well informed.

This is a reference text covering all aspects of renal disease, including: pathology, clinical features, imaging, hypertension, atherosclerotic disease, medical and surgical treatment.