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Renovasculopathies of hypertension in Mexico City
1Department of Pathology, Louisiana State University Medical Center, New Orleans, USA.
Objective:
To examine the severities of renovasculopathies at autopsy in Mexico City, comparing birth cohorts, cause of death categories, and urban versus rural residence.
Design:
Autopsies conducted in 1954, 1974, and 1991 were chosen from archived materials to represent men and women aged 15 to 84 years. Hematoxylin- and eosin-stained sections of kidney were retrieved and evaluated morphometrically.
Setting:
Department of Pathology, Hospital General, Mexico City.
Patients:
Patients of the Hospital General evaluated at autopsy.
Main Outcome Measures:
Renovasculopathies of hypertension include the defining features of benign nephrosclerosis, arterial intimal fibroplasia and arteriolar hyalinization. Fibroplasia is measured as average intimal thickness of renocortical arteries, expressed as percent of outer diameter. Hyalinization is measured by counting the number of affected arterioles in a unit area of cortical section.
Results:
This study confirms a former study that shows much lower levels of renovasculopathy in Mexico City than in blacks and whites of New Orleans. The cohort born in 1894 showed slightly more involvement than those of 1914, 1934, 1954, and 1971, which did not differ from each other. No differences were found between urban and rural residence nor among the categories of tuberculosis, cirrhosis, cancer, and other conditions unrelated to atherosclerosis.
Conclusions:
The remarkable constancy of the renovasculopathies in most comparisons includes little change throughout the 20th century, keeping stable the substantial Mexico-US differences over much of this time frame.