Abstract
A new concept of the etiology and pathogenesis of essential or arteriolar hypertension, based upon the neurogenic theory, has recently been brought forth by Hines and Brown. 1 According to them there exists a primary constitutional factor manifested by a hypersensitive or hyperreactive vasomotor system which is activated by secondary subsidiary factors in the form of environmental, infectious or toxic agents. Furthermore, they advanced the opinion that this constitutional abnormality should be capable of detection in early life, and, to attain this end, devised a standard vasomotor stimulus based upon the blood pressure response to the application of cold.
We have called attention 2 to our discovery of a rather striking difference in the incidence of hypertensive cardiovascular disease in the white and negro races in this locality. We, therefore, felt that, in view of this racial difference, an exceptional opportunity existed to investigate further the possible neurogenic basis of essential hypertension. The “Cold Stimulation Test”, with certain modifications, was applied to 325 young adults, 172 white patients and 153 negroes, approximately equally divided as to sex, and ranging in age from 15 to 35 years, with an average age of 24 years. All subjects were free from cardiovascular disease and had normal blood pressures. After a period of rest in the recumbent position, control blood pressure readings were made at frequent intervals until a constant basal level was reached. The hand and wrist of the opposite arm were then immersed in cold water (4 to 5°C), and determinations were made after 30, 90 and 150 seconds had elapsed. The hand was then removed and readings were made until the blood pressure had returned to its previous resting level.
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