Original communication Society for Vascular Surgery| Volume 26, ISSUE 1, P67-81, July 1949

The corticoadrenal factor in hypertension

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      There are experimental data and clinical observations recorded in the literature which suggest that corticoadrenal activity is a factor at least in some cases of hypertension. In this preliminary study the significance of insulin tolerance, sugar tolerance, and water tolerance has been discussed. Insulin resistance means an activity of pituitary eosinophils, mediated through the adrenal cortex. The sugar tolerance in corticoadrenal stress seems to be diminished, just as in acromegaly. The water tolerance, dependent on a number of factors, is a sensitive index of renal function and has prognostic value as to the expected results from splanchnic section.
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        • Goldblatt M.
        Studies on Experimental Hypertension. V. The Pathogenesis of Experimental Hypertension Due to Renal Ischemia.
        Ann. Int. Med. 1937; 11: 69
        • Blalock A.
        • Levy S.E.
        Studies on the Etiology of Renal Hypertension.
        Ann. Surg. 1937; 106: 826
        • Collins D.A.
        • Wood E.H.
        Experimental Renal Hypertension and Adrenalectomy.
        Am. J. Physiol. 1938; 123: 224
        • Gaudino N.M.
        Las Suprarenales en la Hipertinsion Arterial nel Rogena.
        Rev. Soc. argent. de biol. 1940; 20: 460
        • Williams J.R.
        The Relation of the Adrenal Glands; the Action of the Renal Substance.
        Am. J. M. Sc. 1939; 198: 212
        • Friedman B.
        • Somkin E.
        • Oppenheimer E.F.
        The Relation of Renin to the Adrenal Gland.
        Am. J. Physiol. 1940; 128: 481
        • Remington J.W.
        • Collings S.D.
        • Hays H.W.
        • Parkens W.M.
        • Swingle W.W.
        The Response of the Adrenalectomized Dog to Renin and Other Pressor Agents.
        Am. J. Physiol. 1941; 132: 622
        • Houssay B.A.
        • Dexter L.
        The Sensitivity to Hypertensin, Adrenalin and Renin of Unanaesthetized, Normal, Adrenalectomized, Hypophysectomized and Nephrectomized Dogs.
        Ann. Int. Med. 1942; 17: 451
        • Lewis H.A.
        • Goldblatt H.
        Studies on Experimental Hypertension. XVIII. Experimental Observations on the Humeral Mechanism of Hypertension.
        Bull. New York Acad. Med. 1942; 18: 459
        • Selye H.H.
        The General Adaptation Syndrome and the Diseases of Adaptation.
        J. Clin. Endocrinol. 1946; 6: 117
        • Sayers G.
        • Sayers M.A.
        • Fry E.G.
        • White A.
        • Long C.N.H.
        The Effect of the Adrenotropic Hormone of the Pituitary on the Cholesterol Content of the Adrenal Gland With a Review of the Literature of Adrenal Cholesterol.
        Yale J. Biol. & Med. 1944; 16: 361
        • Dougherty T.F.
        • White A.
        An Evaluation of Alterations Produced in Lymphoid Tissue by Pituitary-Adrenal Cortical Secretion.
        J. Lab. & Clin. Med. 1947; 32: 584
        • Vogt M.
        Observations on Some Conditions Affecting the Rate of Hormone Output by the Suprarenal Cortex.
        J. Physiol. 1944; 103: 317
        • Vogt M.
        Cortical Lipids in the Normal and Denervated Suprarenal Gland Under Stress.
        J. Physiol. 1947; 106: 394
        • Long C.N.H.
        The Conditions Associated With the Secretion of Adrenal Cortex.
        in: Federation Proc. 6. 1947: 461
        • Sarason F.L.
        Adrenal Cortex in Systemic Disease.
        Arch. Int. Med. 1943; 71: 702
        • Rinehart J.F.
        • Williams O.O.
        • Capeller W.S.
        Adenomatous Hyperplasia of the Adrenal Cortex Associated with Essential Hypertension.
        Arch. Path. 1941; 32: 169
        • Bruger M.
        • Rosenkrantz J.A.
        • Loewenstein B.E.
        Studies on the Morphology of Adrenal Cortex and the Excretion of 17 Ketosteroids in Hypertensive Patients.
        Am. J. M. Sc. 1944; 208: 212
        • Dempsey W.S.
        The Adrenal Cortex in Essential Hypertension.
        Arch. Path. 1942; 34: 1031
        • McQuarry J.
        • Johnson R.M.
        • Ziegler M.R.
        Plasma Electrolyte Disturbances in Patients With Hypercortical Syndrome Contrasted With That Found in Addison's Disease.
        Endocrinology. 1937; 21: 762
        • Anderson F.
        • Haymaker W.
        Prolonged Survival of Adrenalectomized Rats, Treated With Sera From Cushing's Disease.
        Science. 1937; 86: 762
        • Heinbecker P.
        The Pathogenesis of the Cushing's Syndrome.
        Medicine. 1944; 23: 225
        • Perera G.A.
        The Relationship of the Adrenal Cortex to Hypertension in a Patient With Hypertensive Vascular Disease.
        J. A. M. A. 1945; 129: 537
        • Perera G.A.
        • Bleed D.W.
        Disturbances in Salt and Water Metabolism in Hypertension.
        Am. J. Med. 1946; 1: 602
        • Perera G.A.
        • Bleed D.W.
        Pressor Activity of Desoxycorticosterone Acetate in Normotensive and Hypertensive Subjects.
        Ann. Int. Med. 1947; 27: 401
        • Grollmann A.
        • Harrison T.R.
        • Mason M.F.
        • Baxter J.
        • Crampton J.
        • Reichsman F.
        Sodium Restriction in the Diet for Hypertension.
        J. A. M. A. 1945; 129: 533
        • Goldman M.L.
        • Schroeder H.A.
        The Immediate Pressor Effect of Desoxycorticosterone Acetate.
        Science. 1948; 107: 272
        • De Takats G.
        • Fowler E.F.
        The Surgical Treatment of Hypertension. III. The Neurogenic Versus Renal Hypertension From the Standpoint of Operability.
        Surgery. 1947; 21: 773
        • De Takats G.
        • Julian O.C.
        • Fowler E.F.
        The Surgical Treatment of Essential Hypertension. IV. Case Selection and Technique as Influencing Results.
        Surgery. 1948; 24: 469
        • Poppen J.L.
        • Lemmon C.
        The Surgical Treatment of Hypertension.
        J. A. M. A. 1947; 134: 1
        • Thorn G.W.
        • Prunty F.T.G.
        • Forsham P.H.
        Changes in Urinary Steroid Excretion and Correlated Metabolic Effects During Prolonged Administration of Adrenocorticotropic Hormone in Man.
        Science. 1947; 105: 528
        • De Takats G.
        • Fenn G.V.
        • Trump R.A.
        Splanchnic Nerve Section in Juvenile Diabetes. I. Selection of Cases for Operation.
        Ann. Int. Med. 1934; 2: 1201
        • De Takats G.
        • Cuthbert F.P.
        The Effect of Celiac Ganglionectomy on the Sugar Tolerance of Dogs.
        Am. J. Physiol. 1932; 102: 614
        • De Takats G.
        • Cuthbert F.P.
        The Effect of Suprarenal Denervation and Splanchnic Nerve Section on the Sugar Tolerance of Dogs.
        Arch. Surg. 1935; 30: 151
        • Jensen M.
        • Grattan J.
        Identity of Glycotropic (Anti-Insulin) Substance of the Anterior Pituitary Gland.
        Am. J. Physiol. 1940; 128: 270
        • Heinbecker P.
        • Rolf D.
        Hypophyseal Eosinophil Cell and Insulin Sensitivity.
        Am. J. Physiol. 1944; 14: 566
        • Kronenberg G.J.
        • McCullough W.S.
        A Brief Insulin-Tolerance Test.
        in: Proc. Soc. Exper. Biol. & Med. 64. 1947: 492
        • Frazer R.
        • Albright F.
        • Smith P.M.
        The Value of the Glucose Tolerance Test, the Insulin Tolerance Test and the Glucose-Insulin Tolerance Test in the Diagnosis of Endocrinologic Disorders of Glucose Metabolism.
        J. Clin. Endocrinol. 1941; 1: 297
        • Soskin S.
        • Levine R.
        Carbohydrate Metabolism Correlation of Physiological, Technical and Clinical Aspects.
        University of Chicago Press, Chicago1946
      1. De Takats, G., and Fowler, E. F.: The Water Tolerance of Hypertensive Patients. Its Relation to Operability, Am. Heart J. (In press.)

        • Soffer L.J.
        • Lesnik G.
        • Sorkin S.Z.
        • Sobotka H.
        • Jacobs M.
        The Utilization of Intravenously Injected Salt in Normals and in Patients With Cushing's Syndrome.
        J. Clin. Investigation. 1944; 23: 51
        • Selye F.L.
        Biochemical Changes in Hypertension.
        Canad. M. A. J. 1947; 57: 325
        • De Courcy J.L.
        • De Courcy L.
        • Theiss O.
        Subtotal Bilateral Adrenalectomy for Hypersuprarenalism.
        J. A. M. A. 1934; 102: 1118