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Low renin hypertension.

Sahay M, Sahay RK - Indian J Endocrinol Metab (2012)

Bottom Line: Low renin hypertension is an important and often underdiagnosed cause of hypertension.It may be associated with high aldosterone levels as in Conn's syndrome or low aldosterone levels as in Liddle syndrome, and syndrome of apparent mineralocorticoid excess, glucocorticoid remediable hypertension etc.Some forms of essential hypertension are also associated with low renin levels.

View Article: PubMed Central - PubMed

Affiliation: Deparment of Nephrology, Osmania General Hospital, Hyderabad, Andhra Pradesh, India.

ABSTRACT
Low renin hypertension is an important and often underdiagnosed cause of hypertension. It may be associated with high aldosterone levels as in Conn's syndrome or low aldosterone levels as in Liddle syndrome, and syndrome of apparent mineralocorticoid excess, glucocorticoid remediable hypertension etc. Some forms of essential hypertension are also associated with low renin levels. Hypokalemia may be an important finding in low renin hypertension. The aldosterone to renin ratio helps in correct diagnosis. The treatment varies with etiology hence an accurate diagnosis is essential. Aldosterone antagonists play an important role in medical management of some varieties of low renin hypertension.

No MeSH data available.


Related in: MedlinePlus

Pathway for adrenal steroid synthesis
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Figure 5: Pathway for adrenal steroid synthesis

Mentions: The adrenal steroid hormones are synthesized in different areas of the adrenal cortex:-Glucocorticoids, androgens, and estrogens in the zona fasciculata and reticularis and Aldosterone in the zona glomerulosa. The substrate for the synthesis of all steroid hormones is cholesterol. The cells of the adrenal cortex either take up cholesterol from the circulation or synthesize cholesterol de novo from acetate. Four distinct cytochrome P450 enzymes are involved in adrenal corticosteroid biosynthesis [Figure 5]. Inherited defects in the enzymatic steps result in different varieties of congenital adrenal hyperplasia (CAH). All varieties of CAH are inherited as autosomal recessive traits. The resulting decrease in cortisol production causes an increase in the secretion of ACTH, which stimulates the production of adrenal steroids up to and including the substrate for the defective enzyme. There may be impaired synthesis of cortisol or impaired synthesis of aldosterone and excessive synthesis of precursor steroids due to the increase in ACTH secretion. In some varieties this results in increases in androgenic hormones (which can cause virilization) and in deoxycorticosterone (which has mineralocorticoid activity and can cause hypertension).[23] The varieties of CAH associated with hypertension include.


Low renin hypertension.

Sahay M, Sahay RK - Indian J Endocrinol Metab (2012)

Pathway for adrenal steroid synthesis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475896&req=5

Figure 5: Pathway for adrenal steroid synthesis
Mentions: The adrenal steroid hormones are synthesized in different areas of the adrenal cortex:-Glucocorticoids, androgens, and estrogens in the zona fasciculata and reticularis and Aldosterone in the zona glomerulosa. The substrate for the synthesis of all steroid hormones is cholesterol. The cells of the adrenal cortex either take up cholesterol from the circulation or synthesize cholesterol de novo from acetate. Four distinct cytochrome P450 enzymes are involved in adrenal corticosteroid biosynthesis [Figure 5]. Inherited defects in the enzymatic steps result in different varieties of congenital adrenal hyperplasia (CAH). All varieties of CAH are inherited as autosomal recessive traits. The resulting decrease in cortisol production causes an increase in the secretion of ACTH, which stimulates the production of adrenal steroids up to and including the substrate for the defective enzyme. There may be impaired synthesis of cortisol or impaired synthesis of aldosterone and excessive synthesis of precursor steroids due to the increase in ACTH secretion. In some varieties this results in increases in androgenic hormones (which can cause virilization) and in deoxycorticosterone (which has mineralocorticoid activity and can cause hypertension).[23] The varieties of CAH associated with hypertension include.

Bottom Line: Low renin hypertension is an important and often underdiagnosed cause of hypertension.It may be associated with high aldosterone levels as in Conn's syndrome or low aldosterone levels as in Liddle syndrome, and syndrome of apparent mineralocorticoid excess, glucocorticoid remediable hypertension etc.Some forms of essential hypertension are also associated with low renin levels.

View Article: PubMed Central - PubMed

Affiliation: Deparment of Nephrology, Osmania General Hospital, Hyderabad, Andhra Pradesh, India.

ABSTRACT
Low renin hypertension is an important and often underdiagnosed cause of hypertension. It may be associated with high aldosterone levels as in Conn's syndrome or low aldosterone levels as in Liddle syndrome, and syndrome of apparent mineralocorticoid excess, glucocorticoid remediable hypertension etc. Some forms of essential hypertension are also associated with low renin levels. Hypokalemia may be an important finding in low renin hypertension. The aldosterone to renin ratio helps in correct diagnosis. The treatment varies with etiology hence an accurate diagnosis is essential. Aldosterone antagonists play an important role in medical management of some varieties of low renin hypertension.

No MeSH data available.


Related in: MedlinePlus