Renomedullary System of Blood Pressure Control Special Lecture

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 1986-04, Vol.8 (4, Part 2 Suppl I), p.I-38-I-46
• Main Author: MUIRHEAD, E ERIC
• Format: Article
• Language: English
• ISSN: 0194-911X; 1524-4563

The renomedullary system of blood pressure control is situated mainly in the renal papilla. The primary functioning unit of this system consists of the renomedullary interstitial cells, situated between the vasa recta, Henleʼs loop, and collecting duct. An intact renomedullary interstitial cell system is protective toward severe, accelerated (“malignant”) hypertension. Thus, failure of this system appears to contribute to the pathogenesis of this hypertensive state. This system modulates the effects of salt on the blood pressure and appears to antagonize actions of angiotensin II and the adrenergic nervous system. The mediator of this system is a prohormone secreted by the renomedullary interstitial cells. This substance is acted on by the liver and converted to its active form. The putative prohormone is the ant (hypertensive neutral renomedullary lipid. This hormone seems to antagonize the actions of angiotensin II, but angiotensin II appears to control its secretion. Failure of the renomedullary interstitial cell system is not a prohypertensive development. Rather, failure of this system appears to allow prohypertensive mechanisms to operate without proper control.