Arteriosclerosis and Hypertension, with Chapters on Blood Pressure: 3rd Edition.Warfield, Louis M. (Louis Marshall)
Science
Arteriosclerosis and Hypertension, with Chapters on Blood Pressure: 3rd Edition.
Warfield, Louis M. (Louis Marshall)
Arteries -- Diseases; Blood pressure
Experimentally, the changes caused by the toxins above noted are
proliferations of cells in the intima and subintimal tissues, and a
breaking up of the internal elastic laminæ into several parallel layers
which stretch themselves among the proliferating cells. The diphtheria
toxin, on the contrary, produces a lesion more like that caused by
adrenalin. All pathologists are not agreed as to whether the
experimental lesions produced by blood pressure raising drugs are
similar to the arteriosclerotic changes in the arteries of man.
Some of the work on rabbits has been discredited for the reason that
arteriosclerosis appears spontaneously in about fifteen per cent of all
laboratory rabbits. Furthermore, comparatively young rabbits have been
found with arteriosclerosis. O. Loeb, however, denies this. He has
examined in the course of eight years 483 healthy rabbits and never
found arterial changes. The spontaneous lesions can not be distinguished
histologically from those due to adrenalin. They differ macroscopically
in that the lesion is usually limited to a few foci near the origin of
the aorta.
Lesions produced by the drugs enumerated above represent one type of
experimental arteriosclerosis. More interesting and important are the
experiments which seem to show that high tension alone is capable of
producing lesions in arteries which in all respects correspond to
Adami's strain hypertrophy and overstrain theory. It has been shown that
when a portion of vein is placed under conditions of high arterial
pressure, as in a transplantation of a portion of vein into a carotid
artery, the vein undergoes marked connective tissue hypertrophy which
includes all the coats. This is evidently strain hypertrophy. Again, it
has been demonstrated that by suspending a previously healthy rabbit by
the hind legs for three minutes daily over a period of three to four
months, there results hypertrophy of the heart with thinning and
dilatation of the arch and the upper part of the thoracic aorta. No
change was found in the abdominal aorta. The carotids, however, were
larger than normal and they showed typical intimal sclerosis with
connective tissue thickening.
Neither I nor others have been able to confirm this experiment, so it is
very doubtful whether mechanical pressure alone can produce true
arteriosclerosis. Some evidence is adduced to bear on this point,
however, in the fact that sclerosis of the pulmonary artery follows
often upon mitral stenosis. Yet we do not know but that factors other
than pressure alone produce the arteriosclerotic change in such cases,
so we are forced back on our conclusion expressed above; viz., that
experiments on animals fail to sustain the purely mechanical origin of
arteriosclerosis.
Public-domain text, read in full here on John Shaqi.
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