That diffuse arteriolar changes occur in the presence of essential hypertension seems well established. However, controversy exists concerning the exact nature, distribution, frequency of occurrence and severity of these changes.
Numerous investigators (Keith, Wagener and Kernohan;1 Cain;2 Moritz and Oldt;3 Fishberg;4 Pilcher and Schwab;5 Morlock,6 and others) have studied the changes occurring in the arterioles of selected organs in cases of hypertension. It has been reported by some investigators (Fishberg; Pilcher and Schwab) that when hypertension is present the changes noted in the arterioles of other organs almost never are observed in the arterioles of the myocardium.
The first suggestion as to the occurrence of vascular change in association with hypertension was embodied in the observation of Bright7 in 1836 that certain patients who had chronic Bright's disease also had noticeable thickening of the blood vessels.Johnson,8 in 1850, observed thickening of the arterior walls of the kidney in