To the Editor.
—Calvin Kunin's original article "Blood Pressure in Patients With Spinal Cord Injury" (Arch Intern Med127:285-287, 1971) provides interesting perspective on the problem of bacteriuria as it relates to development of renal disease and/or hypertension. However I think it is important to comment on two additional points.First, the patients described were traumatically paraplegic or quadriplegic. This group of patients usually manifest the signs of interruption of the descending sympathetic outflow. The sympathetically denervated arterioles may not respond normally to the humoral or other influences which add up to hypertension. Thus the blood pressure experience in this group of patients in relation to bacteriuria is not applicable to patients without spinal cord injuries.Second, the dangerous phenomenon of autonomic hyperreflexia should be mentioned in any article with the above title. This is the occurrence of hypertensive crisis in response to variably intense stimuli below the