Hypertension and Hypertensive Disease

This stimulating monograph represents another brilliant chapter in the slowly unfolding story of arterial hypertension and hypertensive disease. The authors bring together in their relatively small volume the observations, results, and conclusions of a decade and a half of co-ordinated clinical investigation carried on in the Department of Medicine and of Physiology of the New York University College of Medicine. New technics were developed, and are described, for the study of renal functional and hemodynamic phenomena in man, and the new light these unique approaches threw on some aspects of hypertensive disease affords stimulating and provocative reading. Besides demonstrating again that hypertensive disease is a generalized vascular disorder rather than merely the expression of high blood pressure, Doctors Goldring and Chasis establish the major thesis that hypertensive disease in man is fundamentally different from and usually unrelated in genesis to the hypertension that results from experimentally induced renal ischemia in animals. The hope, raised by animal experimentation, that an effective thera*peutic approach may be found in anti-pressor renal extracts or in surgical procedures aimed at correcting renal ischemia is, therefore, regarded as unpromising, and the authors present confirmation for their opinion in a critical review of the clinical experiences thus far reported along these lines. Along with the specific treatment of investigational aspects with which the authors have been personally concerned, the book gives a good clinical delineation of hypertensive disease and all the current therapeutic efforts are discussed. References to the literature of the subject are abundant and apparently well chosen. The few evenings required to read this small volume are certain to be profitably spent by any medical student, internist, urologist, or obstetrican. ARTHUR J. GEIGER.