Word: laragh
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...seemed only natural for Laragh himself to go into medicine. After Cornell University and Cornell University Medical College, he moved to Presbyterian Hospital for his internship. There he came under the tutelage of Dr. Robert Loeb, a great physician who co-edited what has since become one of medicine's standard texts: Cecil & Loeb's Textbook of Medicine. The association was a fortunate one for Laragh. "Loeb was a despot, but a benevolent one," Laragh recalls. "He was fair but demanding, and his standards were the highest." Loeb was also a first-rate teacher who did not believe...
After his internship, Laragh combined research with clinical practice " ("You learn more from patients than you do from samples in a laboratory"). As a cardiologist, he concentrated most of his efforts on the workings-and failings-of the heart. But he also looked elsewhere in the circulatory system, and in 1955 he made an important discovery: he learned that increases in the blood levels of potassium can stimulate the production of aldosterone, an adrenal hormone that raises blood pressure by causing the kidneys to retain salt...
...years that followed, Laragh made even more spectacular findings, which like so many other achievements in science, were serendipitous. Doctors had been aware of the role of aldosterone for some time. But they had been puzzled by the part played by renin,* a kidney hormone produced in response to a drop in blood pressure. Laragh solved the puzzle. In 1958 he and his colleagues began treating a man with malignant hypertension, a rare form of the disease that is characterized by kidney damage and usually kills its victims within a year. Tests showed that the man was, to their surprise...
...Laragh's discoveries, which won him a share in the $50,000 Stouffer Prize in 1969, explained the hormonal controls of blood pressure for the first time. They also permitted the development of a renin profile-a computer-aided analysis of the patient's hormonal output. There are patients with low renin levels who nonetheless have high blood pressure; excess of fluid is probably at the root of their problem. Diuretics counteract this tendency to store salt and fluids, thus lowering the blood pressure. Those with high renin levels can be best helped with renin inhibitors that will...
...Laragh's finding also cleared up another of the mysteries surrounding hypertension. Many hypertensives dismiss the seriousness of their conditions by citing the case of a relative who lived to be 80 despite a blood pressure that nearly popped the mercury out of the doctor's sphygmomanometer. Laragh's work indicates that these exceptions, which seemingly violate the rule that high blood pressure is dangerous, were probably low-renin hypertensives. Patients with this condition are less likely to suffer strokes and heart attacks than high-renin types. But they do not escape hypertension's hazards...