Mechanisms of Experimental and Human Renovascular Hypertension

Goldblatt and his colleagues published their pioneering work on experimental renovascular hypertension in 1934 [58]. They demonstrated that the reduction of renal perfusion pressure, induced by placing a clamp around one renal artery in dogs, produced sustained hypertension. Since this classic experiment, thousands of studies have been done to evaluate the mechanisms involved in the development and maintenance of renovascular hypertension. There are three different ways of increasing blood pressure by narrowing the renal artery with a clamp. Two-kidney- one-clip (2K-1C) hypertension is induced by decreasing renal perfusion pressure in one kidney and leaving the contralateral kidney untouched. In one-kidney, one-clip hypertension, the opposite kidney is removed. Finally, two-kidney, two-clip hypertension is produced when renal perfusion pressure is reduced in both kidneys. The evaluation of the mechanisms responsible for the maintenance of high blood pressure during the acute and chronic phases of hypertension in these experimental models is very important since it is accepted that the same pressor mechanisms are involved in the maintenance of high blood pressure in human renovascular hypertension.