Ultimate Results of Essential Hypertension

Since the recognition and description of hyperpiesia, essential hypertension or vascular hypertonia by Sir Clifford Allbutt,1the condition has slowly been recognized as a clinical entity. By the term essential hypertension, we understand a condition in which the patient has a persistent elevation of the systolic, and usually the diastolic, blood pressure for which there is no demonstrable cause. In the early stages all the patients are without evident cardiac hypertrophy and without demonstrable renal lesions, as evidenced by the fact that the kidneys are able to dilute and concentrate; albumin is rarely present in the urine, and only occasionally a few hyaline casts are found; there is a normal phenolsulphonphthalein excretion, and the chemical components of the blood are normal except for a slight rise in the uric acid content. Eventually, the continued high pressure leads to cardiac hypertrophy and varying degrees of arteriocapillary fibrosis or arteriosclerosis, with