Familial mineralocorticoid induced hypertension in the Sultanate of Oman

In Oman, many hypertensive patients with a family history of the disease respond to treatment with spironolactone, a mineralocorticoid receptor [MC-R] blocking agent thus suggesting a high prevalence of mineralocorticoid [MC] induced disease. The aim of this study was to document the prevalence of MC induced disease in patients with a positive family history of hypertension [HTN]. Serum calcium, potassium, creatinine, aldosterone and renin levels were measured under standard conditions in all patients together with an abdominal ultrasound scan and an adrenal computed tomography [CT] scan in four patients. In this small study, we show that 18 of the 27 patients [66%] had undetectable [suppressed] renin levels with usually normal aldosterone values [14 patients] and respond to treatment with spironoactone. We suggest that MC induced hypertension is likely to be common in the Middle East. In evolutionary terms, this makes sense as the ability to conserve salt in hot climates might be expected to confer a definite survival advantage

Hipertensión arterial y mineralocorticoides: utilidad de las mediciones de renina y aldosterona / Hypertension and mineralcorticoids: usefulness of renin and aldosterone measurements

Recently, some genetic forms of hypertension have been well characterized. These forms can be globally called mineralocorticoid hypertension and are due to different alterations of the renin-angiotensin-aldosterone system (SRAA). Among these, classic primary hyperaldosteronism and its glucocorticoid remediable variety, in which hypertension is secondary to aldosterone production, must be considered. There are also conditions in which mineralocorticoid activity does not depend on aldosterone production. These conditions generate a hyporeninemic hyperaldosteronism, observed in Liddle syndrome, apparent mineralocorticoid hypertension, 11- and 17-hydroxilase deficiency, among others. The detection of these forms of hypertension is only feasible if the renin-angiotensin-aldosterone system is assessed, measuring renin and aldosterone levels. This article reviews these forms of hypertension, their clinical workup and their relevance in the usual hypertensive patients