Document Detail


Genetics of the mineralocorticoid system in primary hypertension.
MedLine Citation:
PMID:  11790287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Abnormalities in steroid biosynthesis have been known for years to cause hypertension in some cases of congenital adrenal hyperplasia. In these patients hypertension usually accompanies a characteristic phenotype with abnormal sexual differentiation. Recently, the molecular basis of four forms of severe hypertension transmitted on an autosomal basis but without additional phenotypic features has been elucidated. All these conditions are characterized primarily by low plasma renin, normal or low serum potassium, and salt-sensitive hypertension, indicating an increased mineralocorticoid effect. These four disorders, the glucocorticoid remediable aldosteronism, the syndrome of apparent mineralocorticoid excess, the activating mutation of the mineralocorticoid receptor, and the Liddle syndrome are a consequence of either abnormal biosynthesis, metabolism, or action of steroid hormones, and are ultimately characterized by an overactivation of the epithelial sodium channel in distal renal tubules. Hyperactivity of this channel results in increased sodium reabsorption and volume expansion leading to an increase in blood pressure as well as potassium loss. With the advent of molecular biology in clinical practice, it has become evident that some genetic defect may present with a more discrete phenotype, with only moderate hypertension with or without hypokalemia as the sole feature. A search for genetic disorders of the mineralocorticoid axis should be an integral part of the diagnostic work-up, particularly in young adults with hypertension.
Authors:
Paolo Ferrari
Related Documents :
20675957 - New approaches to blockade of the renin-angiotensin-aldosterone system: mineralocortico...
18698217 - Blood pressure outcome of adrenalectomy in patients with primary hyperaldosteronism wit...
10218547 - Mineralocorticoid hypertension.
15113447 - Hyponatremic hypertensive syndrome (hhs) in an 18-month old-child presenting as maligna...
1531567 - Effect of detraining on the cardiopulmonary reflex in professional runners and hammer t...
22440087 - Epicatechin: endothelial function and blood pressure.
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current hypertension reports     Volume:  4     ISSN:  1522-6417     ISO Abbreviation:  Curr. Hypertens. Rep.     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-01-15     Completed Date:  2002-04-10     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  100888982     Medline TA:  Curr Hypertens Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  18-24     Citation Subset:  IM    
Affiliation:
Division of Nephrology and Hypertension, Inselspital, University of Berne, Freiburgstrasse 10, 3010 Berne, Switzerland. paolo.ferrari@insel.ch
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adrenal Glands / physiology*
Aldosterone / metabolism
Aldosterone Synthase / genetics*
Humans
Hydrocortisone / metabolism
Hydroxysteroid Dehydrogenases / genetics*,  metabolism
Hypertension / genetics*,  metabolism
Mineralocorticoids / genetics*,  metabolism
Mutation
Potassium / blood
Receptors, Mineralocorticoid / genetics
Renin / blood
Sodium Channels / genetics
Steroid 11-beta-Hydroxylase / genetics*
Chemical
Reg. No./Substance:
0/Mineralocorticoids; 0/Receptors, Mineralocorticoid; 0/Sodium Channels; 50-23-7/Hydrocortisone; 52-39-1/Aldosterone; 7440-09-7/Potassium; EC 1.1.-/Hydroxysteroid Dehydrogenases; EC 1.14.15.4/Aldosterone Synthase; EC 1.14.15.4/Steroid 11-beta-Hydroxylase; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Nonhypertensive cardiac effects of a high salt diet.
Next Document:  Genetic targeting of the renin-angiotensin system for long-term control of hypertension.