Ralph V. Ford

The effect of treatment on the vascular deterioration associated with hypertension, with particular emphasis on renal function☆

Abstract Renal clearance studies were performed in 133 patients with hypertensive vascular disease, 116 of whom were followed for a period of two to five years. In sixty-four of these patients serial renal function studies were performed. Forty-five of the sixty-four were treated and nineteen were untreated. Comparison of treated and untreated patients showed that effective reduction of the blood pressure arrested the renal vascular deterioration associated with hypertension in patients with severe and moderately severe hypertension. Untreated patients with mild and moderately severe hypertension did not show the rapid renal deterioration that occurs in patients with more marked elevation of the blood pressure. The mortality was significantly lower in treated patients than in untreated patients. Renal deterioration was arrested and mortality reduced in patients with malignant hypertension who were treated. Five patients with hypertension due to unilateral renal artery occlusion were studied. Glomerular filtration rate and renal blood flow were reduced significantly in the contralateral kidney as a result of the severe hypertension exhibited by these patients. This vascular deterioration in the unoccluded kidney could be arrested and was partly reversible when the blood pressure was reduced effectively. These results indicate that renal deterioration can be arrested by effective treatment of hypertension and that the lives of hypertensive patients can thus be prolonged. It is recommended therefore that hypertensive vascular disease be treated vigorously and early in the hope of decreasing the morbidity and mortality which too commonly result from this disease.

Subendocardial Infarction: Report of Six Cases and Critical Survey of the Literature

In the ordinary evolution of an acute myocardial infarct the electrocardiogram shows T wave (ischemia), RS-T segment (current of injury) and QRS (death of muscle) changes. This paper presents a special group of cases of infarction in which only T wave and RS-T segment changes developed even when patients were observed over a considerable period. Therefore, the curves as such could not be considered diagnostic of myocardial infarction. The authors here describe a unique and intriguing group of cases of fatal myocardial infarction with electrocardiograms resembling those seen in stress tests for coronary insufficiency and showing rimlike subendocardial infarcts at postmortem.

THE ELECTROCARDIOGRAPHIC CLUE TO VENTRICULAR ANEURYSM

Excerpt Examination of the postmortem records of 99 patients with myocardial infarction who died during the last three years at the Peter Bent Brigham Hospital showed nine instances (or 9.9 per cen...

The vascular status of a heterogeneous group of patients with hypertension, with particular emphasis on renal function

Abstract The renal functional status of 133 patients with hypertension was determined by means of clearance tests. An attempt was made to correlate the renal damage (and other complications of hypertension) with the blood pressure elevation. The results are in general agreement with those obtained by other investigators. There is a definite decrease in glomerular filtration rate and renal blood flow for the group as a whole. As the blood pressure increases there is a progressive decline in renal function and an increased incidence of complications in these patients. Age, sex and race did not appear to influence the disease process in this group of patients. The patients with malignant hypertension tended to have greater renal damage in association with more severe generalized vascular disease.

THE EFFECTS OF CHRONIC PENTAPYRROLIDINIUM-INDUCED HYPOTENSION ON RENAL HEMODYNAMICS AND ON THE EXCRETION OF WATER AND ELECTROLYTES IN HYPERTENSION

Excerpt The aggressive treatment of hypertensive disease has come to occupy a more prominent part in the clinicians interest. This is due to the availability of potent antihypertensive agents. In ...

Laboratory and clinical pharmacodynamics: observations on Win 8778, Win 12,512-2, and Win 13,596-2, and an approach to studying these and similar antihypertensive agents.

Excerpt INTRODUCTION Because of the growing number of new agents available for the treatment of hypertensive diseases, the need for simple, efficient and accurate technics for screening these compo...