Document Detail

The role of adrenal steroidogenesis in arterial hypertension.
MedLine Citation:
PMID:  18493138     Owner:  NLM     Status:  MEDLINE    
Adrenal aldosterone production, the major regulator of salt and water retention, is discussed with respect to hypertensive diseases. Physiological aldosterone production is tightly regulated, either stimulated or inhibited, in the adrenal zona glomerulosa by both circulating factors and/or by locally derived endothelial factors. Arterial hypertension caused by volume overload is the leading clinical symptom indicating increased mineralocorticoid hormones. Excessive aldosterone production is seen in adenomatous disease of the adrenals. The balance between stimulatory/proliferative and antagonistic signaling is disturbed by expression of altered receptor subtypes in the adenomas. Increased aldosterone production without a detectable adenoma is the most frequent form of primary aldosteronism. Both increased sensitivity to agonistic signals and activating polymorphisms within the aldosterone synthase gene (CYP11B2) have been associated with excessive aldosterone production. 17alpha-Hydroxylase deficiency and glucocorticoidremediable aldosteronism can also cause excessive mineralocorticoid synthesis. In contrast, the severe form of pregnancy-induced hypertension, preeclampsia, is characterized by a compromised volume expansion in the presence of inappropriately low aldosterone levels. Initial evidence suggests that compromised CYP11B2 is causative, and that administration of NaCl lowered blood pressure in pregnant patients with low aldosterone availability due to a loss of function.
Markus G Mohaupt
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Endocrine development     Volume:  13     ISSN:  1421-7082     ISO Abbreviation:  Endocr Dev     Publication Date:  2008  
Date Detail:
Created Date:  2008-05-21     Completed Date:  2008-08-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101138956     Medline TA:  Endocr Dev     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  133-44     Citation Subset:  IM    
Division of Hypertension, Department of Nephrology/Hypertension, University of Bern, Bern, Switzerland.
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MeSH Terms
Adrenal Glands / metabolism*,  physiology
Aldosterone / biosynthesis,  deficiency,  physiology
Blood Pressure / physiology
Hyperaldosteronism / etiology,  metabolism,  physiopathology
Hypertension / etiology*,  metabolism
Hypertension, Pregnancy-Induced / etiology
Mineralocorticoids / biosynthesis
Steroids / biosynthesis*,  physiology*
Reg. No./Substance:
0/Mineralocorticoids; 0/Steroids; 52-39-1/Aldosterone

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

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