Actualización en el manejo clínico de la hipertensión hiporreninémica / Update in the clinical management of low renin hypertension
Rev. méd. Chile
;
147(4): 490-498, abr. 2019. tab, graf
Article
in Spanish
| LILACS
| ID: biblio-1014251
ABSTRACT
The renin-angiotensin-aldosterone system modulates volume, sodium and potassium homeostasis. In the setting of a high sodium diet, up to 30% of patients with hypertension have a low or suppressed renin and increased volume. This phenotype of low renin hypertension (LRH) is multifactorial and includes infrequent inherited genetic syndromes, milder phenotypes of classic diseases and environmental exposures. All these conditions have in common a higher cardiovascular risk mediated by the over activation of the mineralocorticoid receptor (MR), present not only in the kidney, but also in vasculature, myocardium and adipocytes. Consequently, the aim of LRH treatment goes beyond the control of blood pressure and requires antagonizing MR with specific pharmacologic agents, pursuing normalization of renin as a clinical objective. Due to the unusual evaluation of renin status by non-endocrinologists and lack of disease awareness, only a minority of hypertensive patients receive this pathophysiologically-driven treatment that should reduce cardiovascular outcomes.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Renin-Angiotensin System
/
Hypertension
Limits:
Humans
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2019
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Pontificia Universidad Católica de Chile/CL
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