RESUMO
This saga is the story of a scientific development. From the search of a mechanism to explain high blood pressure, research was orientated to the functions of an omnipresent biochemical system. And from the search to elucidate the etiology of arterial hypertension, research has ended up studying the local, functional and structural activity of the renin-angiotensin system and the possibilities of interfering with its actions. Since Bright, left ventricular hypertrophy became associated with nephrosclerosis. Later on, clinical studies led Volhard and Fahr to associate nephrosclerosis to high blood pressure while biochemical research led Tigerstedt and Bergmann to demonstrate that renin was associated to high blood pressure. Two teams of investigators, one in Argentina and one in USA discovered the biochemical mechanism by which renin acted on arterioles and later on, two other teams, one in USA and one in England, discovered the biochemical steps leading to the synthesis of angiotensin II. Since Goldblatt's experimental design resulting in a reliable method to obtain arterial hypertension, more than 20 years had to elapse before renal artery stenosis became established as the main cause of clinical secondary arterial hypertension. The renin-angiotensin system became part of a very complex array of substances able to regulate local circulation directly or indirectly and angiotensin has become involved in the remodeling of the smooth muscles of arterioles and myocardium.
Assuntos
Hipertensão/história , Sistema Renina-Angiotensina , Renina/história , Animais , História do Século XIX , História do Século XX , Humanos , Hipertensão/enzimologia , Renina/metabolismo , Sistema Renina-Angiotensina/fisiologiaRESUMO
Several realms of arterial blood pressure are analyzed. 1. The realm of physiological regulation of arterial blood pressure is discussed from the point of view of an intelligent design. 2. The realm of biophysical consequences, the adverse effects, wearing off or senilization and the vascular accidents. 3. The realm of biochemical changes leading to cellular changes. The ecological equilibrium and the interpretation of purposeful reactions. From metaphore to purpose. 4. The realm of cellular changes as a result of biophysical factors. The society of cells. 5. The realm of metabolic environment. 6. The realm of adverse effects of increasing arterial blood pressure instead of selecting less risky mechanisms. A politically mistaken decision.
Assuntos
Pressão Sanguínea/fisiologiaRESUMO
This saga is the story of a scientific development. From the search of a mechanism to explain high blood pressure, research was orientated to the functions of an omnipresent biochemical system. And from the search to elucidate the etiology of arterial hypertension, research has ended up studying the local, functional and structural activity of the renin-angiotensin system and the possibilities of interfering with its actions. Since Bright, left ventricular hypertrophy became associated with nephrosclerosis. Later on, clinical studies led Volhard and Fahr to associate nephrosclerosis to high blood pressure while biochemical research led Tigerstedt and Bergmann to demonstrate that renin was associated to high blood pressure. Two teams of investigators, one in Argentina and one in USA discovered the biochemical mechanism by which renin acted on arterioles and later on, two other teams, one in USA and one in England, discovered the biochemical steps leading to the synthesis of angiotensin II. Since Goldblatts experimental design resulting in a reliable method to obtain arterial hypertension, more than 20 years had to elapse before renal artery stenosis became established as the main cause of clinical secondary arterial hypertension. The renin-angiotensin system became part of a very complex array of substances able to regulate local circulation directly or indirectly and angiotensin has become involved in the remodeling of the smooth muscles of arterioles and myocardium.
RESUMO
Several realms of arterial blood pressure are analyzed. 1. The realm of physiological regulation of arterial blood pressure is discussed from the point of view of an intelligent design. 2. The realm of biophysical consequences, the adverse effects, wearing off or senilization and the vascular accidents. 3. The realm of biochemical changes leading to cellular changes. The ecological equilibrium and the interpretation of purposeful reactions. From metaphore to purpose. 4. The realm of cellular changes as a result of biophysical factors. The society of cells. 5. The realm of metabolic environment. 6. The realm of adverse effects of increasing arterial blood pressure instead of selecting less risky mechanisms. A politically mistaken decision.
RESUMO
The observation of the eye-ground allows the recognition of atheromatous emboli within the arterial lumen and some of the characteristics of the evolution of such an accident. An analogy is drawn with pathological observations and clinical findings. The increased use of arterial invasive diagnostic and therapeutic procedures has increased the chances of producing atheroembolism giving the opportunity of observing its pathological and clinical consequences. We comment on the factors that could explain the lack of recognition and demonstration of cholesterol embolism. Lack of awareness is still the main factor.
Assuntos
Embolia de Colesterol/etiologia , Embolia de Colesterol/complicações , Embolia de Colesterol/diagnóstico , Fundo de Olho , Músculos/patologiaRESUMO
The observation of the eye-ground allows the recognition of atheromatous emboli within the arterial lumen and some of the characteristics of the evolution of such an accident. An analogy is drawn with pathological observations and clinical findings. The increased use of arterial invasive diagnostic and therapeutic procedures has increased the chances of producing atheroembolism giving the opportunity of observing its pathological and clinical consequences. We comment on the factors that could explain the lack of recognition and demonstration of cholesterol embolism. Lack of awareness is still the main factor.
