Actualización en el manejo clínico de la hipertensión hiporreninémica

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 include...

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Autores principales:	Macchiavello,Stefano, Fardella,Carlos, Baudrand,René
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2019
Materias:	Aldosterone Hypertension Receptors, Mineralocorticoids Renin Spironolactone
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000400490
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spelling	oai:scielo:S0034-988720190004004902019-08-14Actualización en el manejo clínico de la hipertensión hiporreninémicaMacchiavello,StefanoFardella,CarlosBaudrand,René Aldosterone Hypertension Receptors, Mineralocorticoids Renin Spironolactone 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.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.147 n.4 20192019-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000400490es10.4067/S0034-98872019000400490
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Aldosterone Hypertension Receptors, Mineralocorticoids Renin Spironolactone
spellingShingle	Aldosterone Hypertension Receptors, Mineralocorticoids Renin Spironolactone Macchiavello,Stefano Fardella,Carlos Baudrand,René Actualización en el manejo clínico de la hipertensión hiporreninémica
description	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.
author	Macchiavello,Stefano Fardella,Carlos Baudrand,René
author_facet	Macchiavello,Stefano Fardella,Carlos Baudrand,René
author_sort	Macchiavello,Stefano
title	Actualización en el manejo clínico de la hipertensión hiporreninémica
title_short	Actualización en el manejo clínico de la hipertensión hiporreninémica
title_full	Actualización en el manejo clínico de la hipertensión hiporreninémica
title_fullStr	Actualización en el manejo clínico de la hipertensión hiporreninémica
title_full_unstemmed	Actualización en el manejo clínico de la hipertensión hiporreninémica
title_sort	actualización en el manejo clínico de la hipertensión hiporreninémica
publisher	Sociedad Médica de Santiago
publishDate	2019
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000400490
work_keys_str_mv	AT macchiavellostefano actualizacionenelmanejoclinicodelahipertensionhiporreninemica AT fardellacarlos actualizacionenelmanejoclinicodelahipertensionhiporreninemica AT baudrandrene actualizacionenelmanejoclinicodelahipertensionhiporreninemica
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Actualización en el manejo clínico de la hipertensión hiporreninémica

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