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Renal Medulla in Hypertension. 2024
Allen W Cowley, and
Richard J Roman, and
David L Mattson, and
Kleber G Franchini, and
Paul M O'Connor, and
Ayako Makino, and
Norman E Taylor, and
Louise C Evans, and
Takefumi Mori, and
Jeffrey G Dickhout, and
Chunhua Jin, and
Noriyuki Miyata, and
Kazushige Nakanishi, and
Mátyás Szentiványi, and
Frank Park, and
Meredith M Skelton, and
Theresa Kurth, and
Satoshi Shimada
Department of Physiology, Medical College of Wisconsin, Milwaukee (A.W.C., M.M.S., T.K., S.S.).
Studies have found that blood flow to the renal medulla is an important determinant of pressure-natriuresis and the long-term regulation of arterial pressure. First, a brief review of methods developed enabling the study of the medullary circulation is presented. Second, studies performed in rats are presented showing medullary blood flow plays a vital role in the pressure-natriuresis relationship and thereby in hypertension. Third, it is shown that chronic reduction of medullary blood flow results in hypertension and that enhancement of medullary blood flow reduces hypertension hereditary models of both salt-sensitive rats and salt-resistant forms of hypertension. The key role that medullary nitric oxide production plays in protecting this region from ischemic injury associated with circulating vasoconstrictor agents and reactive oxygen species is presented. The studies cited are largely the work of my students, research fellows, and colleagues with whom I have performed these studies dating from the late 1980s to more recent years.
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