Actualización en el manejo clínico de la hipertensión hiporreninémica



Título del documento: Actualización en el manejo clínico de la hipertensión hiporreninémica
Revista: Revista médica de Chile
Base de datos: PERIÓDICA
Número de sistema: 000429284
ISSN: 0034-9887
Autors: 1
1
1
Institucions: 1Pontificia Universidad Católica de Chile, Facultad de Medicina, Santiago de Chile. Chile
Any:
Període: Abr
Volum: 147
Número: 4
Paginació: 490-498
País: Chile
Idioma: Español
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés 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
Disciplines Medicina
Paraules clau: Sistema cardiovascular,
Hipertensión,
Receptores químicos,
Aldosterona,
Renina,
Mineralocorticoides,
Espironolactona
Keyword: Cardiovascular system,
Hypertension,
Chemical receptors,
Aldosterone,
Renin,
Mineralocorticoids,
Spironolactone
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