| Journal: | Revista médica de Chile |
| Database: | PERIÓDICA |
| System number: | 000429284 |
| ISSN: | 0034-9887 |
| Authors: | Macchiavello, Stefano1 Fardella, Carlos1 Baudrand, René1 |
| Institutions: | 1Pontificia Universidad Católica de Chile, Facultad de Medicina, Santiago de Chile. Chile |
| Year: | 2019 |
| Season: | Abr |
| Volumen: | 147 |
| Number: | 4 |
| Pages: | 490-498 |
| Country: | Chile |
| Language: | Español |
| Document type: | Artículo |
| Approach: | Analítico, descriptivo |
| English 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 |
| Disciplines: | Medicina |
| Keyword: | Sistema cardiovascular, Hipertensión, Receptores químicos, Aldosterona, Renina, Mineralocorticoides, Espironolactona |
| Keyword: | Cardiovascular system, Hypertension, Chemical receptors, Aldosterone, Renin, Mineralocorticoids, Spironolactone |
| Full text: | Texto completo (Ver HTML) |
