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Glucocorticoid-induced hypertension.

Julie E Goodwin¹, David S Geller

¹Section of Nephrology, Department of Pediatrics, Yale University School of Medicine, 333 Cedar Street, PO Box 208064, New Haven, CT 06520, USA. julie.goodwin@yale.edu

Pediatric Nephrology (Berlin, Germany)

|July 12, 2011

Summary

Glucocorticoid-induced hypertension, often linked to the mineralocorticoid receptor, also involves the glucocorticoid receptor in its development and persistence. Understanding this dual role is key to improving treatment strategies for high blood pressure.

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Area of Science:

Endocrinology
Nephrology
Cardiovascular Medicine

Background:

Glucocorticoid-induced hypertension is a prevalent clinical issue with suboptimal treatment strategies due to incomplete understanding.
Current understanding often overemphasizes the renal mineralocorticoid receptor's role in sodium and water reabsorption.

Purpose of the Study:

To review recent advancements in understanding the pathogenesis of glucocorticoid-induced hypertension.
To highlight the significant role of the glucocorticoid receptor in hypertension development and maintenance.

Main Methods:

Review of experimental and clinical data from human and animal models.
Analysis of in vitro studies on kidney tissues, vascular smooth muscle, and endothelial cells.
Application of mouse genetics to investigate tissue-specific contributions.

Main Results:

Evidence suggests the glucocorticoid receptor plays a crucial role alongside the mineralocorticoid receptor in hypertension.
The glucocorticoid receptor is expressed in key blood pressure-regulating organs: kidney, brain, and vasculature.
Mouse genetic models have enabled the study of tissue-specific roles in vivo.

Conclusions:

The glucocorticoid receptor is implicated in both the initiation and perpetuation of glucocorticoid-induced hypertension.
A comprehensive understanding requires considering both mineralocorticoid and glucocorticoid receptor pathways.
Further research into glucocorticoid receptor signaling is essential for optimizing hypertension management.