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Updated: June 3, 2025
The term "simple hypertrophy" is generally restricted to hypertrophy of the left ventricle without any cardiac excuse the hypertrophy by hypertension and hard physical labor. It is well recognized that it hypertrophies with hypertension and with chronic interstitial nephritis.
These classes are given here in the order of the seriousness of the prognosis. One of the most common causes of hypertension is clue to excess of eating and drinking. The products caused by maldigestion of proteins, and the toxins formed and absorbed especially from meat proteins, particularly when the excretions are insufficient, are the most frequent causes of hypertension.
Patients under iodid need not be seen so frequently; those under nitroglycerin or alkalies still less frequently. But all patients under the active management of hypertension should be seen at from one to three week intervals, and the urine should be repeatedly examined and the blood pressure carefully recorded.
It is better not to use drugs of any kind in this incipient condition. The hypertension should be regulated by the diet; the purin bases and meat should be reduced to a minimum; tea, coffee and alcohol should be prohibited, and tobacco should be either entirely stopped or reduced to a minimum.
Although these patients may live for many years, they are likely to have an apoplexy, cerebral disease or an aneurysm. While hypertension is not a disease, and while it often should not be combated, still, as it is always the forerunner of more serious trouble, there can be no excuse for not most seriously considering it and generally attempting its reduction.
The development of permanent injury to one or more valves of the heart may have been watched by the physician who cares for a patient with acute endocarditis, or it may have been noted early during the progress of arteriosclerosis or other conditions of hypertension.
Lead may be a cause of increased blood pressure, and diabetics occasionally have a high pressure, although more frequently there is a lowering of blood pressure in diabetes. Richman believes that syphilis is the most common cause of hypertension and arteriosclerosis without renal disease. When arteriosclerosis and renal disease are combined, of course the highest systolic readings occur.
In some cases the iris becomes adherent to the head of the ciliary processes and, when atrophy of the ciliary body occurs, is drawn backward at the base of the iris by the receding tissues. If the hypertension persists or is repeated at varying periods, a slow atrophy of the uveal tract sets in.
Probably often a myocarditis and perhaps some fatty degeneration are at the base of such a slowed heart after serious infections. A heart which has not always been slow but has gradually become slow with the progress of hypertension and arteriosclerosis will often disclose on postmortem examination serious lesions of the coronary arteries.
This is thought to be a defect in development. The changes that occur in the tissues of the eye appear to be largely due to the stretching consequent on the more or less uniform distentions of the globe as a result of hypertension. Cornea. Fissures occur in Descemet's membrane. Anterior Chamber. This is very deep in the greater number of cases. However, this rule has many exceptions.
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